SHINY JACOB – Psychiatric/Mental Health Nurse Practitioner, NPI 1700638293
Psychiatric/Mental Health Nurse Practitioner
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
16,360 NURSE PRACTITIONER in CA
Provider Addresses for SHINY JACOB
1030 NEVADA ST
REDLANDS, CA 923742957
Phone: (909) 553-0055
Type: Location
5360 CORISON WAY
FONTANA, CA 923365995
Phone: (909) 553-0055
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
Loading prescription activity...
Open Payments (CMS)
CMS reports 5 Open Payments records for all available years, with a total value of $111.
Total Amount is formed as General ($111) + Research ($0) + Ownership ($0) = $111.
Last reported payment date: 2024-12-13 • Largest payer in this snapshot: Janssen Pharmaceuticals, Inc ($44).
Total Amount
$111
General + Research + Ownership
Payments
5
Total payment records
General Amount
$111
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-13
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Janssen Pharmaceuticals, Inc | $44 |
| Neurocrine BioSciences Inc. | $38 |
| Sage Therapeutics, Inc. | $29 |
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: 2025-05-12
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 |
|---|---|---|---|---|
| I20250512000435 | I | Nurse Practitioner | CA | 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.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 92374)
Loading plans...
Group practice members
| Name | Specialty | State |
|---|---|---|
| Clinical Psychologist | CA | |
| Nurse Practitioner | CA | |
| Nurse Practitioner | CA | |
| P S Y C H I A T R Y | CA | |
| Nurse Practitioner | CA | |
| Nurse Practitioner | CA | |
| P S Y C H I A T R Y | CA | |
| Nurse Practitioner | CA |
Reviews
All reviews are moderated before publication. Reviews reflect users' opinions; we do not verify the accuracy of individual reviews.
No reviews yet. Be the first to share your experience — your opinion helps families compare providers.