DR. SHELLEY SUE JAQUISH (M.D.) – Otolaryngology Physician, NPI 1558329300
Otolaryngology Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
732 OTOLARYNGOLOGY in FL
Provider Addresses for DR. SHELLEY SUE JAQUISH (M.D.)
6827 FIRST AVENUE SOUTH
SUITE 100
ST PETERSBURG, FL 337074516
Phone: (727) 341-0551
Fax: (727) 341-0332
Type: Location
900 Carillon Pkwy Ste 300
St Petersburg, FL 337161118
Phone: (727) 341-0551
Fax: (727) 341-0332
Type: Location
10002 PRINCESS PALM AVE STE 332
TAMPA, FL 336198327
Phone: (813) 571-7184
Fax: (813) 654-4695
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 144 Open Payments records for all available years, with a total value of $3,830.
Total Amount is formed as General ($3,830) + Research ($0) + Ownership ($0) = $3,830.
Last reported payment date: 2024-12-18 • Largest payer in this snapshot: AstraZeneca Pharmaceuticals LP ($665).
Total Amount
$3,830
General + Research + Ownership
Payments
144
Total payment records
General Amount
$3,830
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-18
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| AstraZeneca Pharmaceuticals LP | $665 |
| GlaxoSmithKline, LLC. | $635 |
| Regeneron Healthcare Solutions, Inc. | $531 |
| Neurent Medical Limited | $331 |
| Optinose US, Inc. | $219 |
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: 2003-12-10
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 |
|---|---|---|---|---|
| I20031210000743 | I | Otolaryngology | FL | 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 |
|---|---|---|---|---|
| 95004 | Test for allergy using allergenic extract | 1,702 | 28 | $0 |
| 95165 | Professional service for preparation and provision of 1 or more antigens | 995 | 60 | $0 |
| 95024 | Test for allergy using allergenic extract injected into skin | 929 | 25 | $0 |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 473 | 308 | $0 |
| 95117 | Professional service for multiple injections of allergen | 414 | 43 | $0 |
Insurance plans in this area (ZIP 33707)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| OTOLARYNGOLOGY | FL | 92567 | Eardrum testing using ear probe | 54 | 47 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| O T O L A R Y N G O L O G Y | FL | |
| O T O L A R Y N G O L O G Y | FL | |
| O T O L A R Y N G O L O G Y | FL | |
| Physician Assistant | WI | |
| O T O L A R Y N G O L O G Y | FL | |
| O T O L A R Y N G O L O G Y | FL | |
| O T O L A R Y N G O L O G Y | FL | |
| Qualified Audiologist | FL | |
| Physician Assistant | FL | |
| O T O L A R Y N G O L O G Y | FL |
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