MR. JESSE SHAW (DO) – Orthopaedic Surgery Physician, NPI 1396865788

MR. JESSE SHAW (DO) is a healthcare provider. based in Pembroke pines, Florida. specializing in GENERAL PRACTICE. They hold the professional credentials DO. They hold a License No. OS10003 (FL). The NPI Number for MR. JESSE SHAW (DO) is 1396865788

Main info

Male
Sole Proprietor
24 Years Of Experience
Accepts Medicare Assignment
Name
MR. JESSE SHAW (DO)
NPI
1396865788
Phone
(954) 450-0099
Address
17779 SW 2ND ST
Enumeration Date
30 March 2007
Last Update Date
27 August 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
9543221110
Graduation Year
2002 (24 years ago)
PAC ID
1557455789
Group Practice PAC ID
5092960898
Professional Enrollment ID
I20070919000646
Address ID
FL330293924PE17779STXX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience62
Completeness85
Years active:19State licenses:1Digital endpointsOther names

1,466 GENERAL PRACTICE in FL

Provider Addresses for MR. JESSE SHAW (DO)

  • 17779 SW 2ND ST

    PEMBROKE PINES, FL 330293924

    Phone: (954) 450-0099

    Fax: (954) 450-0022

    Type: Location

  • 1435 W 49th Pl Ste 402

    Hialeah, FL 330123147

    Phone: (954) 399-5976

    Fax: (954) 322-1099

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 20 Open Payments records for all available years, with a total value of $10,540.

Total Amount is formed as General ($10,540) + Research ($0) + Ownership ($0) = $10,540.

Last reported payment date: 2024-11-14 • Largest payer in this snapshot: NovoSource, LLC ($9,450).

Total Amount

$10,540

General + Research + Ownership

Payments

20

Total payment records

General Amount

$10,540

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-11-14

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: 2007-09-19

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
I20070919000646IGeneral PracticeFLTBD

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
99214Established patient office or other outpatient visit, 30-39 minutes262100$0
20610Aspiration and/or injection of fluid from large joint9545$0
J1030Injection, methylprednisolone acetate, 40 mg6648$0
99204New patient office or other outpatient visit, 45-59 minutes5050$0
73560X-ray of knee, 1-2 views1918$0
View full utilization report →

Insurance plans in this area (ZIP 33029)

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Provider's Procedures

MR. JESSE SHAW (DO) performs procedures in GENERAL PRACTICE. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
ORTHOPEDIC SURGERYFL20610Aspiration and/or injection of large joint or joint capsule9260

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: 5092960898View full group profile
NameSpecialtyState
Orthopedic SurgeryFL
Orthopedic SurgeryFL
Nurse PractitionerFL

Reviews

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Frequently asked questions

How do payers reference MR. JESSE SHAW (DO)?
For MR. JESSE SHAW (DO), use NPI 1396865788 as the unique 10-digit identifier.
Is MR. JESSE SHAW (DO) still an active registrant?
MR. JESSE SHAW (DO) carries an active NPI according to the public dataset.
What kind of doctor is MR. JESSE SHAW (DO)?
MR. JESSE SHAW (DO) is associated with Orthopaedic Surgery Physician in the directory — Clinical services aligned with this taxonomy classification.
What locale is associated with MR. JESSE SHAW (DO)?
Directory geography for MR. JESSE SHAW (DO) centers on Pembroke Pines, Florida.
What does 3 location(s) imply?
3 practice locations appear in the available data.

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