JEFF SHAW – Acute Care Nurse Practitioner, NPI 1457970022

JEFF SHAW is a healthcare provider. based in Stratford, Connecticut. specializing in NURSE PRACTITIONER. They hold a License No. 153286 (CT). The NPI Number for JEFF SHAW is 1457970022

Main info

Male
Sole Proprietor
6 Years Of Experience
Accepts Medicare Assignment
Name
JEFF SHAW
NPI
1457970022
Phone
(917) 605-3326
Address
30 PEQUONNOCK CIR
Enumeration Date
13 April 2020
Last Update Date
17 September 2020

Doctor Profile

Medical School Name
OTHER
Secondary Phone
8602245011
Graduation Year
2020 (6 years ago)
PAC ID
7416369095
Group Practice PAC ID
3173866241
Professional Enrollment ID
I20201225000006
Address ID
CT060522016NE100XXSTXX300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience45
Completeness75
Years active:6State licenses:2Digital endpointsOther names

4,196 NURSE PRACTITIONER in CT

Provider Addresses for JEFF SHAW

  • 30 PEQUONNOCK CIR

    STRATFORD, CT 066142313

    Phone: (917) 605-3326

    Type: Mailing

  • 80 SEYMOUR ST

    HARTFORD, CT 061028000

    Phone: (917) 605-3326

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 3 Open Payments records for all available years, with a total value of $247.

Total Amount is formed as General ($247) + Research ($0) + Ownership ($0) = $247.

Last reported payment date: 2024-09-30 • Largest payer in this snapshot: W. L. Gore & Associates, Inc. ($188).

Total Amount

$247

General + Research + Ownership

Payments

3

Total payment records

General Amount

$247

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-09-30

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

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: 2020-12-25

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

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20201225000006INurse PractitionerCTTBD

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.

Verify on CMS Revalidation Lookup Tool

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

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99221Initial hospital care with straightforward or low level of medical decision making, per day, if using time, at least 40 minutes2424$0
View full utilization report →

Insurance plans in this area (ZIP 06614)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 3173866241View full group profile
NameSpecialtyState
-CT
Nurse PractitionerCT
Nurse PractitionerCT
-CT
-CT
-CT
Internal MedicineCT
Internal MedicineCT
Nurse PractitionerCT
Cardiac Electrophysiology, Cardiovascular Disease (Cardiology)CT

Reviews

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Frequently asked questions

What unique ID ties claims to JEFF SHAW?
NPI 1457970022 is assigned to JEFF SHAW under the national enumeration system.
Is JEFF SHAW's enrollment marked active?
An active flag here means the NPI record is not in a deactivated state.
What field does JEFF SHAW work in?
You can think of JEFF SHAW as practicing within Acute Care Nurse Practitioner. Clinical services aligned with this taxonomy classification.
What location metadata exists for JEFF SHAW?
The page summarizes Stratford, Connecticut for JEFF SHAW; expand the address list for detail.
What if Stratford, Connecticut seems incomplete?
Street-level detail can be omitted — open the full address list for this NPI.

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