JERRELL WAYNE SHAW (CRNA) – Certified Registered Nurse Anesthetist, NPI 1659561470

JERRELL WAYNE SHAW (CRNA) is a healthcare provider. based in Mesquite, Texas. specializing in CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA). They hold the professional credentials CRNA. They hold a License No. 578398 (TX). The NPI Number for JERRELL WAYNE SHAW (CRNA) is 1659561470

Main info

Male
44 Years Of Experience
Accepts Medicare Assignment
Name
JERRELL WAYNE SHAW (CRNA)
NPI
1659561470
Phone
(972) 681-7246
Address
3500 INTERSTATE 30
Enumeration Date
27 July 2007
Last Update Date
18 December 2007

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2149465165
Graduation Year
1982 (44 years ago)
PAC ID
3375524580
Group Practice PAC ID
0749338861
Professional Enrollment ID
I20040525000831
Address ID
TX752082363DA221XXIIXX601
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience50
Completeness75
Years active:18State licenses:1Digital endpointsOther names

5,279 CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA) in TX

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Provider Addresses for JERRELL WAYNE SHAW (CRNA)

  • Interstate 30, Mesquite, Dallas County, Texas, 75150, United States

    MESQUITE, TX 751502651

    Phone: (972) 681-7246

    Fax: (972) 681-8946

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 2 Open Payments records for all available years, with a total value of $36.

Total Amount is formed as General ($36) + Research ($0) + Ownership ($0) = $36.

Last reported payment date: 2024-10-03 • Largest payer in this snapshot: Boston Scientific Corporation ($18).

Total Amount

$36

General + Research + Ownership

Payments

2

Total payment records

General Amount

$36

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-10-03

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

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: 2004-05-25

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
I20040525000831ICertified Registered Nurse Anesthetist (Crna)TXTBD

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.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
00811Anesthesia for other procedure on large bowel using an endoscope7373$0
00813Anesthesia for procedure on small and large bowel using an endoscope3131$0
00731Anesthesia for other procedure on esophagus, stomach, or upper small bowel using an endoscope2525$0
01440Anesthesia for other procedure on artery of knee1413$0
01500Anesthesia for other procedure on artery of lower leg1212$0
View full utilization report →

Insurance plans in this area (ZIP 75150)

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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: 0749338861View full group profile
NameSpecialtyState
Certified Registered Nurse Anesthetist (Crna)TX
Certified Registered Nurse Anesthetist (Crna)TX
-TX
Certified Registered Nurse Anesthetist (Crna)TX

Reviews

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Frequently asked questions

Is JERRELL WAYNE SHAW (CRNA) listed with a National Provider Identifier?
Yes — JERRELL WAYNE SHAW (CRNA) has NPI 1659561470 on file in the registry.
Would JERRELL WAYNE SHAW (CRNA) appear as active to a payer?
You can treat JERRELL WAYNE SHAW (CRNA) as active for directory purposes; confirm clinical privileges separately.
What area of care is associated with JERRELL WAYNE SHAW (CRNA)?
JERRELL WAYNE SHAW (CRNA)'s record emphasizes Certified Registered Nurse Anesthetist. Clinical services aligned with this taxonomy classification.
Is JERRELL WAYNE SHAW (CRNA) associated with Mesquite?
Public fields place JERRELL WAYNE SHAW (CRNA) around Mesquite, Texas. Always confirm the exact site before visiting.
What does 2 location(s) imply?
2 practice locations appear in the available data.

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