Jacob Shively
NPI 1215672928 · Nurse Practitioner · Fort Wayne, IN
Enrolled with Medicare as Practitioner - Nurse Practitioner · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Jacob Shively is a Nurse Practitioner provider in Fort Wayne, IN (NPI 1215672928).
Provider details
- NPI number
- 1215672928
- Entity type
- Individual
- Primary specialty
- Nurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
- Sex
- Male
- Sole proprietor
- No
- License
- 71012742A (IN)
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure28% of score
4 yrs in NPPES registry
- Profile completeness28% of score
100% of core fields populated
- Practice footprint17% of score
2 documented practice locations
- Medicare service volume (vs. specialty peers)28% of score
235 Medicare services, 2024 (ranked within specialty)
Medicare volume is ranked against active providers in the same specialty. Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
What this provider does (Medicare)
Based on Medicare fee-for-service claims, 2024; not all care is captured.
| Service (HCPCS) | Medicare services | Typical Medicare-allowed (2024) |
|---|---|---|
| Initial Hospital Care With Moderate Level of Medical Decision Making, If Using Time, at Least 75 Minutes99223 | 96 | $136 |
| Initial Hospital Care With Straightforward Or Low-Level Medical Decision Making, If Using Time, at Least 55 Minutes99222 | 71 | $102 |
| Initial Hospital Care With Straightforward Or Low Level of Medical Decision Making, Per Day, If Using Time, at Least 40 Minutes99221 | 68 | $64 |
Typical Medicare-allowed amounts for these services range $64–$136 (2024). The Medicare-allowed amount is what Medicare recognizes for a service under fee-for-service — a reference figure for 2024, not a price quote and not what you would be billed. Medicare Part B covers roughly an eighth of all NPIs (65+ skew); services with fewer than 11 beneficiaries are suppressed by CMS. Source: CMS Medicare Physician & Other Practitioners, by Provider & Service.
Practice location
Mailing address
Additional practice locations (1)
- 11104 Parkview Circle Dr Ste 110Fort Wayne, IN 46845-1673Phone: (260) 425-6780Fax: (260) 425-6789
Registry dates
- Enumerated
- 2022-04-28
- Last updated
- 2023-11-01
- Certified
- 2023-11-01
Frequently asked questions
- What is Jacob Shively's NPI number?
- Jacob Shively's National Provider Identifier (NPI) is 1215672928, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What is Jacob Shively's specialty?
- Jacob Shively is listed in the NPPES registry with a primary specialty of Nurse Practitioner (Physician Assistants & Advanced Practice Nursing Providers).
- Where is Jacob Shively located?
- Jacob Shively's practice location on file with NPPES is 11104 Parkview Circle Dr Ste 330, Fort Wayne, IN 46845-1674.
- What is Jacob Shively's phone number?
- The practice phone number listed in the NPPES registry for Jacob Shively is (260) 494-3484.
- Does Jacob Shively accept Medicare?
- Jacob Shively is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Is Jacob Shively's NPI active?
- Yes — Jacob Shively's NPI (1215672928) is active in the NPPES registry as of the last update on 2023-11-01.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.