SHELBY FORD – Physician Assistant, NPI 1295375020

SHELBY FORD is a healthcare provider. based in Wilmington, Massachusetts. specializing in PHYSICIAN ASSISTANT. They hold a License No. PA7954 (MA). The NPI Number for SHELBY FORD is 1295375020

Main info

Female
6 Years Of Experience
Accepts Medicare Assignment
Name
SHELBY FORD
NPI
1295375020
Phone
(631) 219-2543
Address
4111 AVALON DR
Enumeration Date
9 January 2020
Last Update Date
27 August 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
6179837000
Graduation Year
2020 (6 years ago)
PAC ID
3971911231
Group Practice PAC ID
3870405988
Professional Enrollment ID
I20210427000020
Address ID
MA021303446JA1153XSTXX300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience46
Completeness85
Years active:6State licenses:1Digital endpointsOther names

5,091 PHYSICIAN ASSISTANT in MA

Provider Addresses for SHELBY FORD

  • 4111 AVALON DR

    WILMINGTON, MA 018871162

    Phone: (631) 219-2543

    Type: Mailing

  • 14 PROSPECT ST

    MILFORD, MA 017573003

    Phone: (508) 473-1190

    Type: Mailing

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: 2021-04-27

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
I20210427000020IPhysician AssistantMATBD

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 01887)

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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: 3870405988View full group profile
NameSpecialtyState
N E U R O S U R G E R YMD
-MA
Critical Care (Intensivists), Pulmonary DiseaseFL
Physician AssistantMA
N E U R O L O G YMA
Nurse PractitionerMA
Orthopedic SurgeryMA
Physician AssistantNH
Nurse PractitionerMA
P A T H O L O G YMA

Reviews

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Frequently asked questions

What is the registry number for SHELBY FORD?
The registry entry for SHELBY FORD shows NPI 1295375020.
Quick check: is SHELBY FORD active?
Public NPPES data shows SHELBY FORD with an active NPI status right now.
Which specialty label fits SHELBY FORD?
NPPES ties SHELBY FORD to Physician Assistant in the taxonomy section. Clinical services aligned with this taxonomy classification.
Which community is linked to SHELBY FORD?
SHELBY FORD shows a connection to Wilmington, Massachusetts in registry-derived data.
Can I export SHELBY FORD's record?
You can download the official NPPES record; we summarize key fields for readability.

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