JEANIE RAY SHADE LCSW
NPI 1659048809
Social Worker - Clinical in Bentonville, AR
About Jeanie Ray Shade Lcsw NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
JEANIE RAY SHADE LCSW (NPI 1659048809) is an individual clinical provider in Bentonville, Arkansas, licensed in Arkansas (12579-C) and active in the NPI registry since August 2021. She is enrolled in Medicare PECOS and is a graduate of Other (2010).
NPPES Registry Identity
Specialties & Licenses
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Jeanie Ray Shade Lcsw is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.
Medicare Billing Reassignment
Medicare enrollment records show Jeanie Shade reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
San Francisco, CA 94131
- Reassigned Medicare billing, Arkansas enrollment
- 16 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 72712 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Other Providers at the Same Location NPPES 6
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Jeanie Shade's NPI number?
The NPI number for Jeanie Shade is 1659048809. It was assigned to this individual provider in the NPPES registry on August 25, 2021.
Where is Jeanie Shade located?
Jeanie Shade practices at 1001 SE 28th St, Bentonville, AR 72712. The listed phone number is (479) 403-2915.
What is Jeanie Shade's specialty?
The primary specialty registered for this NPI is Social Worker, specializing in Clinical, with taxonomy code 1041C0700X.
Is Jeanie Shade enrolled in Medicare?
Yes. Jeanie Shade is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.
Which organization bills Medicare for Jeanie Shade's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Jeanie Shade reassigns Medicare benefits to Brightside Medical Of Michigan PC (San Francisco, CA). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Jeanie Shade's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Jeanie Shade accept?
Health plans from Blue Cross and Blue Shield of Montana, Health Advantage and Octave list Jeanie Shade as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for Jeanie Shade was last updated on December 6, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Jeanie Ray Shade, LCSW · NPI 1659048809
Clinical provider in Bentonville, Arkansas. Individual provider, active in the CMS NPPES registry since August 25, 2021.
## Identity
- **NPI:** 1659048809 (Entity type: Individual)
- **Enumerated:** August 25, 2021
- **Primary specialty:** Social Worker - Clinical · taxonomy 1041C0700X
- **State license:** 12579-C (Arkansas)
- **Sole proprietor:** Yes
## Practice location
- **Address:** 1001 SE 28TH ST, Bentonville, AR 72712-3205
- **Phone:** (479) 403-2915
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment
- **Bills Medicare through:** Brightside Medical Of Michigan PC (NPI 1144800350, San Francisco, CA), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2010
## Record status
- **NPPES last updated:** December 6, 2023
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Source: [NPI Profile](https://npiprofile.com/npi/1659048809) · Data from the CMS NPPES public registry.