Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

JESSE DANIEL SHAW D.O
NPI 1912293572
Family Medicine - Sports Medicine in Stillwater, OK

Q: What is Jesse Shaw's NPI number?

The NPI number for Jesse Shaw is 1912293572. It was assigned to this individual provider in the NPPES registry on June 22, 2011.

Q: What is Jesse Shaw's specialty?

The primary specialty registered for this NPI is Family Medicine, specializing in Sports Medicine, with taxonomy code 207QS0010X.

Q: When was this NPI record last updated?

The NPPES record for Jesse Shaw was last updated on September 16, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 42 days 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.

Active since June 22, 2011PECOS EnrolledAccepts Medicare Assignment

170 ATHLETICS CENTER, STILLWATER, OK 74078(405) 744-5430 Get Directions Write a Review

NPPES record last updated: September 16, 2026. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Sep 16, 2026, Aug 8, 2026, Aug 4, 2025 and 4 more (7 updates tracked since 2018).

On this page

About Jesse Daniel Shaw D.o NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JESSE DANIEL SHAW D.O (NPI 1912293572) is an individual sports medicine provider in Stillwater, Oklahoma, licensed in Oklahoma (9600) and active in the NPI registry since June 2011. He is enrolled in Medicare PECOS, is affiliated with Pullman Regional Hospital, and is a graduate of Other (2019).

NPPES Registry Identity

NPI1912293572

Entity TypeIndividualMale

Primary Taxonomy207QS0010X

Provider Legal NameJESSE DANIEL SHAWCredential: D.O

Location Address170 ATHLETICS CENTERStillwater, OK 74078-0001

Mailing Address5310 E 31st St Ste 13Tulsa, OK 74135-5013 · (918) 561-5701 · Fax (918) 561-1173

Phone(405) 744-5430

Sole ProprietorYes

Medical School CMSOtherGraduated 2019

Enumeration DateJune 22, 2011

Last NPPES UpdateSeptember 16, 20267 updates tracked since enumeration

NPPES CertifiedSeptember 16, 2026

✔ NPI 1912293572 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily Medicine · Sports MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207QS0010X

License✔ Licensed in OK · 9600

Definition

A family medicine physician that is trained to be responsible for continuous care in the field of sports medicine, not only for the enhancement of health and fitness, but also for the prevention of injury and illness. A sports medicine physician must have knowledge and experience in the promotion of wellness and the prevention of injury. Knowledge about special areas of medicine such as exercise physiology, biomechanics, nutrition, psychology, physical rehabilitation, epidemiology, physical evaluation, injuries (treatment and prevention and referral practice) and the role of exercise in promoting a healthy lifestyle are essential to the practice of sports medicine. The sports medicine physician requires special education to provide the knowledge to improve the health care of the individual engaged in physical exercise (sports) whether as an individual or in team participation.

170 ATHLETICS CENTER, Stillwater, OK 74078

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter Health, Premera Blue Cross Blue Shield of Alaska.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

Jesse Daniel Shaw D.o 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.

PECOS PAC ID8921386897

PECOS Enrollment IDI20231006003297

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignments

Medicare enrollment records show Jesse Shaw reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Public Hospital District #1-A Of Whitman County

1,268 mi

Critical Access

835 SE BISHOP BLVD
Pullman, WA 99163

Reassigned Medicare billing, Washington enrollment
151 clinicians in this Medicare group

NPI 1366446767 (509) 332-2514

Tuality Medical Group LLC

1,496 mi

Neurology

364 SE 8TH AVE STE 101
Hillsboro, OR 97123

Reassigned Medicare billing, Oregon enrollment
691 clinicians in this Medicare group

NPI 1639690704 (503) 681-1000

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 14

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Hyaluronan or derivative, synvisc or synvisc-one, for intra-articular injection, 1 mg J7325

Synvisc or Synvisc-One is a treatment involving an injection of a substance called hyaluronan into your joints. This substance, naturally found in the body, helps lubricate and cushion your joints, reducing pain and improving mobility. It's often used for arthritis patients.

816 services14 patients

Injection, dexamethasone sodium phosphate, 1 mg J1100

Dexamethasone sodium phosphate is a medication given via injection. It is a type of steroid that helps reduce inflammation and immune responses. It can be used to treat a variety of conditions, such as allergies, skin conditions, arthritis, and more.

378 services46 patients

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

67 services55 patients

X-ray of knee, 4 or more views 73564

An X-ray of the knee, 4 or more views, is a non-invasive imaging test. It involves capturing multiple images of your knee from different angles. This helps in diagnosing conditions such as fractures, arthritis, or infections. The procedure is quick and painless.

38 services31 patients

Aspiration and/or injection of fluid from large joint 20610

This procedure involves using a needle to remove (aspiration) or introduce (injection) fluid into a large joint like the knee or hip. It can help diagnose conditions, relieve discomfort, or deliver medication directly to the joint.

37 services31 patients

New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204

This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.

29 services29 patients

Aspiration and/or injection of fluid large joint using ultrasound guidance 20611

This procedure involves using ultrasound technology to accurately locate a large joint, usually the knee or shoulder. A needle is then inserted to either extract fluid (aspiration) or inject medication. The ultrasound helps ensure precision and safety.

28 services24 patients

New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203

This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.

25 services25 patients

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

20 services18 patients

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

19 services18 patients

X-ray of knee, 4 or more views 73564

16 services12 patients

X-ray of shoulder, minimum of 2 views 73030

An X-ray of the shoulder, with a minimum of 2 views, is a non-invasive imaging test. It uses a small amount of radiation to produce images of your shoulder bones. This helps in diagnosing conditions like fractures, arthritis, or other abnormalities. The procedure is quick and painless.

15 services15 patients

New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204

14 services14 patients

Aspiration and/or injection of fluid from large joint 20610

13 services13 patients

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Pullman Regional Hospital

Critical Access Hospitals · Pullman, WA

5/5 CMS rating

OwnershipGovernment - Hospital District or Authority

CMS Certification Number501331

Location835 S Bishop BlvdPullman, WA 99163 · Whitman County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 74078 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$82.46 typical visit price

range $53.00 – $162.61

Typical copayment $20.61 (range $13.25 – $40.65)

Most-billed visit code 99203

Established Patient

$94.27 typical visit price

range $16.68 – $132.40

Typical copayment $23.56 (range $4.17 – $33.10)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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.

PARKER JOENS PT, DPT, CSCS

Physical Therapist

170 ATHLETICS CENTER
STILLWATER, OK 74078

Payne County (405) 744-5430

VAL GENE IVEN M.D.

Internal Medicine (Sports Medicine)

170 ATHLETICS CENTER, OSU SPORTSMEDICINE
STILLWATER, OK 74078

Payne County (405) 744-5430

OKLAHOMA STATE UNIVERSITY

Preferred Provider Organization

170 ATHLETICS CENTER
STILLWATER, OK 74078

Payne County (405) 744-5430

JACK O'NEIL DPT

Physical Medicine & Rehabilitation (Sports Medicine)

170 ATHLETICS CENTER
STILLWATER, OK 74078

Payne County (425) 591-2804

NICHOLAUS GOLDSTEIN ATC

Specialist/Technologist (Athletic Trainer)

170 ATHLETICS CENTER
STILLWATER, OK 74078

Payne County (970) 685-8839

MISS CECILIA ANN LANE ATC, LAT

Specialist/Technologist (Athletic Trainer)

170 ATHLETICS CENTER
STILLWATER, OK 74078

Payne County (316) 648-8941

LINDSEY MERRYMAN PT, DPT, SCS, AT

Physical Therapist

170 ATHLETICS CENTER
STILLWATER, OK 74078

Payne County (405) 744-2112

KEELY ELIZABETH NICKEL PA-C

Physician Assistant

170 ATHLETICS CENTER
STILLWATER, OK 74078

Payne County (405) 744-5430

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 Jesse Shaw's NPI number?

The NPI number for Jesse Shaw is 1912293572. It was assigned to this individual provider in the NPPES registry on June 22, 2011.

Where is Jesse Shaw located?

Jesse Shaw practices at 170 Athletics Center, Stillwater, OK 74078. The listed phone number is (405) 744-5430.

What is Jesse Shaw's specialty?

The primary specialty registered for this NPI is Family Medicine, specializing in Sports Medicine, with taxonomy code 207QS0010X.

Is Jesse Shaw enrolled in Medicare?

Yes. Jesse Shaw 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 organizations bill Medicare for Jesse Shaw's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Jesse Shaw reassigns Medicare benefits to 2 organizations: Public Hospital District #1-A Of Whitman County (Pullman, WA) and Tuality Medical Group LLC (Hillsboro, OR). Each 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 Jesse Shaw's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Jesse Shaw accept?

Health plans from Ambetter Health and Premera Blue Cross Blue Shield of Alaska list Jesse Shaw 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.

Is Jesse Shaw affiliated with any hospitals?

According to CMS data, Jesse Shaw is affiliated with Pullman Regional Hospital.

When was this NPI record last updated?

The NPPES record for Jesse Shaw was last updated on September 16, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 42 days 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.