JESSICA SYDNEY SHANE (APRN) – Acute Care Nurse Practitioner, NPI 1730058090

JESSICA SYDNEY SHANE (APRN) is a healthcare provider. based in Lakewood ranch, Florida. specializing in NURSE PRACTITIONER. They hold the professional credentials APRN. They hold a License No. 11043287 (FL). The NPI Number for JESSICA SYDNEY SHANE (APRN) is 1730058090

Main info

Female
1 Year Of Experience
Accepts Medicare Assignment
Name
JESSICA SYDNEY SHANE (APRN)
NPI
1730058090
Phone
Not provided
Address
8918 WHITE SAGE LOOP
Enumeration Date
4 November 2025
Last Update Date
4 November 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
9419178900
Graduation Year
2025 (1 year ago)
PAC ID
3072007426
Group Practice PAC ID
1355240177
Professional Enrollment ID
I20251212000300
Address ID
FL342392913SA1921XSTXX307
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience24
Completeness85
Years active:0State licenses:1Digital endpointsOther names

24,243 NURSE PRACTITIONER in FL

Provider Addresses for JESSICA SYDNEY SHANE (APRN)

  • 8918 WHITE SAGE LOOP

    LAKEWOOD RANCH, FL 342026410

    Phone:

    Type: Mailing

  • 1700 S TAMIAMI TRL

    SARASOTA, FL 342393555

    Phone: (941) 917-9000

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

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: 2025-12-12

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

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

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20251212000300INurse PractitionerFLTBD

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.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 34202)

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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: 1355240177View full group profile
NameSpecialtyState
Critical Care (Intensivists)FL
N E U R O L O G YFL
General SurgeryFL
-FL
-FL
Cardiovascular Disease (Cardiology)FL
Certified Registered Nurse Anesthetist (Crna)FL
-FL
Cardiovascular Disease (Cardiology), Peripheral Vascular DiseaseFL
Nurse PractitionerFL

Reviews

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Frequently asked questions

How is JESSICA SYDNEY SHANE (APRN) identified in CMS data?
CMS-hosted NPPES data lists JESSICA SYDNEY SHANE (APRN) with NPI 1730058090.
Can I rely on JESSICA SYDNEY SHANE (APRN) being an active provider?
As of the registry snapshot, JESSICA SYDNEY SHANE (APRN) is marked active.
What is JESSICA SYDNEY SHANE (APRN)'s primary classification?
Acute Care Nurse Practitioner is the headline specialty for JESSICA SYDNEY SHANE (APRN) here. Clinical services aligned with this taxonomy classification.
What address line appears for JESSICA SYDNEY SHANE (APRN)?
JESSICA SYDNEY SHANE (APRN)'s geographic hint is Lakewood Ranch, Florida in our summary view.
How many locations tie to this NPI?
2 practice locations appear in the available data.

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