SHANE POLATIS (PT, DPT) – Physical Therapist, NPI 1871909630

SHANE POLATIS (PT, DPT) is a healthcare provider. based in Henderson, Nevada. specializing in PHYSICAL THERAPIST IN PRIVATE PRACTICE. They hold the professional credentials PT, DPT. They hold a License No. 2983 (NV). The NPI Number for SHANE POLATIS (PT, DPT) is 1871909630

Main info

Male
12 Years Of Experience
Accepts Medicare Assignment
Name
SHANE POLATIS (PT, DPT)
NPI
1871909630
Phone
(702) 818-1717
Address
1386 S Boulder Hwy Ste 100
Enumeration Date
1 July 2014
Last Update Date
21 September 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
7028181770
Graduation Year
2014 (12 years ago)
PAC ID
9830418680
Group Practice PAC ID
8224561766
Professional Enrollment ID
I20150429002256
Address ID
NV891196145LA4794XAVEX401
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience56
Completeness75
Years active:11State licenses:1Digital endpointsOther names

880 PHYSICAL THERAPIST IN PRIVATE PRACTICE in NV

Provider Addresses for SHANE POLATIS (PT, DPT)

  • 1386 S Boulder Hwy Ste 100

    Henderson, NV 890156958

    Phone: (702) 818-1717

    Type: Location

  • 2411 W HORIZON RIDGE PKWY

    SUITE 100

    HENDERSON, NV 890525779

    Phone: (702) 458-1300

    Type: Mailing

  • 2250 POSTAL DR

    SUITE 4

    PAHRUMP, NV 890484797

    Phone: (775) 727-8900

    Type: Location

  • 4794 S EASTERN AVE STE A

    LAS VEGAS, NV 891196145

    Phone: (702) 818-1770

    Type: Location

  • 9550 S EASTERN AVE STE 253

    LAS VEGAS, NV 891238042

    Phone: (702) 818-1770

    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: 2015-04-29

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
I20150429002256IPhysical Therapist In Private PracticeNVTBD

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 89015)

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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: 8224561766View full group profile
NameSpecialtyState
Physical Therapist In Private PracticeNV

Reviews

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Frequently asked questions

Is there an official ID for SHANE POLATIS (PT, DPT) in U.S. healthcare records?
The official identifier for SHANE POLATIS (PT, DPT) is NPI 1871909630.
Active or inactive — what applies to SHANE POLATIS (PT, DPT)?
You should see SHANE POLATIS (PT, DPT) as active in CMS-hosted NPPES data.
What clinical focus is listed for SHANE POLATIS (PT, DPT)?
At a glance, SHANE POLATIS (PT, DPT) is tied to Physical Therapist. Clinical services aligned with this taxonomy classification.
What practice footprint exists for SHANE POLATIS (PT, DPT)?
Travel planning: use Henderson, Nevada as the reference point for SHANE POLATIS (PT, DPT), then confirm.
Can I trust this NPI listing for SHANE POLATIS (PT, DPT)?
The listing is sourced from the national NPI registry. If something looks off, compare with NPPES and the clinic's website.

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