DR. JORDAN TYLER SHIVELY (D.O.) – Surgery Physician, NPI 1194170910
Surgery Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
308 GENERAL SURGERY in NV
Provider Addresses for DR. JORDAN TYLER SHIVELY (D.O.)
363 PILOT MOUNTAIN RD
BULLS GAP, TN 377112322
Phone: (423) 754-2832
Type: Mailing
8930 W SUNSET RD STE 300
LAS VEGAS, NV 891485013
Phone: (702) 228-8834
Type: Mailing
20000 Harvard Ave
Warrensville Heights, OH 441226805
Phone: (216) 491-7464
Fax: (216) 491-7802
Type: Location
20000, Harvard Avenue, Warrensville Heights, Cuyahoga County, Ohio, 44122, United States
WARRENSVILLE HEIGHTS, OH 441226805
Phone: (216) 491-7464
Fax: (216) 491-7802
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 13 Open Payments records for all available years, with a total value of $7,815.
Total Amount is formed as General ($7,815) + Research ($0) + Ownership ($0) = $7,815.
Last reported payment date: 2024-09-10 • Largest payer in this snapshot: Intuitive Surgical, Inc. ($7,092).
Total Amount
$7,815
General + Research + Ownership
Payments
13
Total payment records
General Amount
$7,815
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-09-10
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Intuitive Surgical, Inc. | $7,092 |
| Davol Inc. | $413 |
| Endologix LLC | $234 |
| TELA Bio, Inc. | $48 |
| Ethicon US, LLC | $27 |
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: 2021-09-29
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20210929001997 | I | General Surgery | NV | 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 |
|---|---|---|---|---|
| 99203 | New patient office or other outpatient visit, 30-44 minutes | 123 | 123 | $0 |
| 99223 | Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes | 54 | 54 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 39 | 33 | $0 |
| 99441 | Telephone medical discussion with physician, 5-10 minutes | 37 | 31 | $0 |
| 99231 | Subsequent hospital care with straightforward or low level of medical decision making, per day, if using time, at least 25 minutes | 28 | 24 | $0 |
Insurance plans in this area (ZIP 37711)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| General Surgery | NV | |
| Vascular Surgery | NV | |
| Vascular Surgery | NY | |
| Vascular Surgery | NV | |
| General Surgery | PA | |
| General Surgery | NV | |
| General Surgery | CA | |
| Physician Assistant | NV | |
| General Surgery | NV | |
| General Surgery, Thoracic Surgery, Vascular Surgery | NV |
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