JORDAN SHAW (APRN) – Family Nurse Practitioner, NPI 1164872263
Family Nurse Practitioner
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
3,550 NURSE PRACTITIONER in KS
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Provider Addresses for JORDAN SHAW (APRN)
2100 Powell Street, Bay Trail, Emeryville, Alameda County, California, 94608, United States
SUITE 900
EMERYVILLE, CA 946081826
Phone: (510) 350-2777
Type: Mailing
Via Christi Hospital Saint Francis, 929, North Saint Francis Street, Wichita, Sedgwick County, Kansas, 66214, United States
WICHITA, KS 672143821
Phone: (316) 268-8050
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 2 Open Payments records for all available years, with a total value of $159.
Total Amount is formed as General ($159) + Research ($0) + Ownership ($0) = $159.
Last reported payment date: 2024-10-29 • Largest payer in this snapshot: ABIOMED ($142).
Total Amount
$159
General + Research + Ownership
Payments
2
Total payment records
General Amount
$159
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-10-29
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| ABIOMED | $142 |
| Merck Sharp & Dohme LLC | $17 |
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2016-08-04
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20160804001633 | I | Nurse Practitioner | KS | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 99285 | Emergency department visit with high level of medical decision making | 104 | 104 | $0 |
| 93010 | Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only | 55 | 54 | $0 |
| 99284 | Emergency department visit with moderate level of medical decision making | 51 | 49 | $0 |
Insurance plans in this area (ZIP 94608)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Emergency Medicine | MO | |
| - | CA | |
| - | KS | |
| Nurse Practitioner | KS | |
| Nurse Practitioner | KS | |
| Physician Assistant | KS | |
| - | KS | |
| Emergency Medicine | PA | |
| Emergency Medicine | KS | |
| Nurse Practitioner | KS |
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