JACLYN KRISTIN SHEA
NPI 1861168411
Nurse Practitioner - Family in Medford, NY
About Jaclyn Kristin Shea NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
JACLYN KRISTIN SHEA (NPI 1861168411) is an individual family provider in Medford, New York, licensed in New York (348300) and active in the NPI registry since August 2021. She is enrolled in Medicare PECOS and is a graduate of Other (2021).
NPPES Registry Identity
Specialties & Licenses
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Jaclyn Kristin Shea 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.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 11763 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Medicare Quality Performance CMS QPP · MIPS
Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.
Other Providers at the Same Location NPPES 8
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
MEDFORD, NY 11763
MEDFORD, NY 11763
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 Jaclyn Shea's NPI number?
The NPI number for Jaclyn Shea is 1861168411. It was assigned to this individual provider in the NPPES registry on August 23, 2021.
Where is Jaclyn Shea located?
Jaclyn Shea practices at 1723 N Ocean Ave, Medford, NY 11763. The listed phone number is (631) 758-5858.
What is Jaclyn Shea's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.
Is Jaclyn Shea enrolled in Medicare?
Yes. Jaclyn Shea 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.
When was this NPI record last updated?
The NPPES record for Jaclyn Shea was last updated on March 10, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.
# Jaclyn Kristin Shea · NPI 1861168411
Family physician in Medford, New York. Individual provider, active in the CMS NPPES registry since August 23, 2021.
## Identity
- **NPI:** 1861168411 (Entity type: Individual)
- **Enumerated:** August 23, 2021
- **Primary specialty:** Nurse Practitioner - Family · taxonomy 363LF0000X
- **State license:** 348300 (New York)
- **Sole proprietor:** Yes
## Practice location
- **Address:** 1723 N OCEAN AVE, Medford, NY 11763-2687
- **Phone:** (631) 758-5858
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Medical school:** Other, class of 2021
## Record status
- **NPPES last updated:** March 10, 2022
---
Source: [NPI Profile](https://npiprofile.com/npi/1861168411) · Data from the CMS NPPES public registry.