Jacob C Shively
Nurse Practitioner โข Fort Wayne, IN
11104 Parkview Circle Dr Ste 330
Fort Wayne, IN 468451674
This profile restates public CMS/NPPES data; T-MedInfo gives no medical advice — consult a licensed professional, and call 911 for emergencies.
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NPI assigned on April 28, 2022; this date does not establish years in practice.
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Published CMS data list 235 Original Medicare Part B services in 2024.
Source: CMS, Medicare Physician & Other Practitioners โ by Provider and Service, 2024. Published rows only; this is not a quality measure.
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Published Part B service records, 2024:
- 99223 โ Initial hospital care with moderate level of medical decision making: 96 service units.
- 99222 โ Initial hospital care with straightforward or low-level medical decision making: 71 service units.
- 99221 โ Initial hospital care with straightforward or low level of medical decision making, per day: 68 service units.
Source: CMS, Medicare Physician & Other Practitioners โ by Provider and Service, 2024. Units differ by code; these are not visits or a measure of quality.
CPTยฎ only copyright 2023 American Medical Association. All rights reserved. Service names are shortened from CPT Consumer Friendly Descriptors (CMS data, 2024). CPT notice
See the full table ยท Guide: How to read Medicare Part B data
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Close to the middle for Medicare Part B services among clinicians listed under Nurse Practitioner in Fort Wayne, IN (2024, 343 clinicians with data). Median for this group: 190. Middle half: 99 to 379.
Close to the middle for Medicare Part B services among clinicians listed under Nurse Practitioner in Indiana (2024, 1,359 clinicians with data). Median for this group: 253. Middle half: 110 to 600.
Source: CMS, Medicare Physician & Other Practitioners โ by Provider and Service, 2024. Billing and prescribing volume is not a quality rating.
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Medicare Part B services went from 43 in 2023 to 235 in 2024.
Source: CMS, Medicare Physician & Other Practitioners โ by Provider and Service, 2023โ2024.
Practice Location & Contact Primary Location
11104 Parkview Circle Dr Ste 330
Fort Wayne, IN 468451674
Matched by practice address or phone in NPPES. A shared address or phone does not confirm that this clinician works there.
NPPES lists 1 additional practice-address record in Fort Wayne, IN. See the list
Source: CMS NPPES NPI Registry, practice location records; release date unavailable.
CMS Doctors and Clinicians lists 1 group name: Nephrology Associates Of Northern Indiana Pc. See the list
Source: CMS Doctors and Clinicians National Downloadable File, CMS release of October 2, 2026.
Listings do not confirm current availability, employment or a shared ownership network.
Medicare Profile & Education
Source: CMS Doctors and Clinicians National Downloadable File, CMS release of October 2, 2026
2021
What Public CMS Data Show
Nurse Practitioner: NPPES taxonomy is a reported classification, not proof of board certification.
Medicare patients
203 people with Original Medicare in 2024
It gives a sense of how many people with Medicare this clinician treated that year.
Source: CMS, Medicare Physician & Other Practitioners โ by Provider, 2024.
Medicare-allowed amount
About $24,746 in 2024
The total amount Medicare approved for these services in 2024. It includes what Medicare paid and what patients or their other insurance owed, such as the deductible and coinsurance.
It shows the total cost of this clinician's Original Medicare services under Medicare's fee rules.
What this does not show: Medicare-allowed amount
This is not the clinician's income. Part of it can go to a clinic or group practice, staff, equipment or drugs. It is not the price you will pay.
Source: CMS, Medicare Physician & Other Practitioners โ by Provider and Service, 2024.
Paid by Medicare
About $19,464 in 2024
The part of the Medicare-allowed amount that Medicare itself paid in 2024, after patients' deductibles and coinsurance.
The gap between the allowed amount and this number is roughly what patients and their other insurance paid.
What this does not show: Paid by Medicare
This is not the clinician's income and not a measure of quality.
Source: CMS, Medicare Physician & Other Practitioners โ by Provider and Service, 2024.
Industry payments (Open Payments)
Fewer than 11 payment records totaling $13.49 in 2025
Drug and medical device companies must report certain payments to doctors and some other clinicians to CMS, such as meals, travel, speaking fees or research funding.
It shows reported financial ties between this clinician and companies. You can ask your clinician about them.
These records are submitted by drug and medical device companies, and a reported payment does not necessarily mean the financial relationship is improper.
General: payments not tied to research, such as meals, travel, consulting or speaking fees.
A reported payment does not necessarily mean the financial relationship is improper. Research payments can go to a hospital or university for a study the clinician leads, not to the clinician personally. Clinicians can dispute records with the company that reported them.
Source: CMS Open Payments, program year 2025.
Years since graduation
5 years (graduated 2021)
CMS Doctors and Clinicians data list 2021 as the year this clinician finished professional school.
It tells you roughly how long ago the clinician finished school.
What this does not show: Years since graduation
It is not the number of years in practice, and more years does not mean better care.
Source: CMS Doctors and Clinicians National Downloadable File, CMS release of October 2, 2026.
NPI first issued
2022
The year this clinician's National Provider Identifier (NPI) was issued. An NPI is a unique 10-digit ID that US health care providers use for billing.
What this does not show: NPI first issued
NPIs have been issued only since 2005, so this year is not necessarily when the clinician started practicing.
Source: CMS NPPES NPI Registry.
Accepts Medicare assignment
CMS data list this clinician as accepting Medicare assignment. This means agreeing to take the Medicare-approved amount as full payment for covered services.
With Original Medicare, you usually pay only your deductible and coinsurance, and the office sends the claim to Medicare for you.
Medicare assignment applies to Original Medicare. It does not tell you whether the clinician is in a Medicare Advantage plan's network, accepts other insurance, or is taking new patients.
Source: CMS Doctors and Clinicians, CMS release of October 2, 2026; Medicare.gov, โDoes your provider accept Medicare as full payment?โ
No telehealth indicator
CMS shows this indicator only when recent Medicare claims include telehealth services. The clinician may still offer telehealth; ask the office.
Source: CMS, Telehealth Indicator on Medicare Care Compare (fact sheet, January 2023); CMS Doctors and Clinicians, CMS release of October 2, 2026.
Enrolled in Medicare (PECOS)
Jacob Shively has a Medicare enrollment record in PECOS, the CMS system clinicians use to enroll so they can bill Medicare or order services for people with Medicare.
It does not show whether the clinician accepts assignment, is in your plan's network, or is taking new patients.
Source: CMS Medicare Fee-For-Service Public Provider Enrollment (PECOS); CMS Order and Referring file.
Can order Medicare-covered services
CMS lists Jacob Shively as eligible to order or refer Medicare Part B clinical laboratory and imaging services, durable medical equipment (DME) and home health services for people with Medicare.
Medicare pays for these items and services only when they are ordered by an eligible clinician.
What this does not show: Can order Medicare-covered services
It does not mean the clinician offers these services directly.
Source: CMS Medicare Fee-For-Service Public Provider Enrollment (PECOS); CMS Order and Referring file.
Compared with the same specialty in Fort Wayne and Indiana
Billing and prescribing volume is not a quality rating.
Medicare Part B services
Close to the middle for clinicians listed under Nurse Practitioner in Fort Wayne, IN (2024, 343 clinicians with data). Median for this group: 190. Middle half: 99 to 379.
Close to the middle for clinicians listed under Nurse Practitioner in Indiana (2024, 1,359 clinicians with data). Median for this group: 253. Middle half: 110 to 600.
Medicare-allowed amount
A higher Medicare-allowed amount than 70% of clinicians listed under Nurse Practitioner in Fort Wayne, IN (2024, 343 clinicians with data). Median for this group: $15,134. Middle half: $7,373 to $25,892.
A higher Medicare-allowed amount than 60% of clinicians listed under Nurse Practitioner in Indiana (2024, 1,359 clinicians with data). Median for this group: $18,971. Middle half: $7,776 to $39,524.
Paid by Medicare
A higher Medicare payment amount than 70% of clinicians listed under Nurse Practitioner in Fort Wayne, IN (2024, 343 clinicians with data). Median for this group: $10,944. Middle half: $5,370 to $19,644.
A higher Medicare payment amount than 60% of clinicians listed under Nurse Practitioner in Indiana (2024, 1,359 clinicians with data). Median for this group: $13,711. Middle half: $5,567 to $28,699.
532 active clinicians are listed under Nurse Practitioner with a practice address in Fort Wayne, IN (2,598 in Indiana).
Addresses are self-reported to NPPES and may be out of date.
Telehealth indicator in Fort Wayne
22.2% of these 532 clinicians have the CMS telehealth indicator.
72.2% of these 532 clinicians are listed by CMS as accepting Medicare assignment.
CMS data by year
Changes may reflect reporting, coverage or privacy limits, not changes in care quality.
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Medicare Part B services
Medicare Part B services increased 447% from 43 in 2023 to 235 in 2024.
- 2023: 43
- 2024: 235
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Medicare-allowed amount
Medicare-allowed amount increased 588% from $3,597 in 2023 to $24,746 in 2024.
- 2023: $3,597
- 2024: $24,746
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Paid by Medicare
Paid by Medicare increased 591% from $2,815 in 2023 to $19,464 in 2024.
- 2023: $2,815
- 2024: $19,464
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Industry payments (Open Payments)
Industry payments (Open Payments) went from $64.96 in 2022 to $13.49 in 2025.
- 2022: $64.96
- 2023: $81.58
- 2025: $13.49
Sources: CMS Medicare Physician & Other Practitioners (2024), CMS Open Payments (2025), CMS Doctors and Clinicians, CMS release of October 2, 2026, CMS NPPES NPI Registry. Specialty names follow the NUCC Health Care Provider Taxonomy.
Text: T-MedInfo ยท Report an error.
Pharma & Medical Device Financial Disclosures
Payments and other transfers of value that drug and medical device companies reported to CMS Open Payments
Program year 2025 (payments made January 1 โ December 31, 2025): fewer than 11 records totaling $13.49.
| Manufacturer | Payment Nature | Product | Type | Amount ($) |
|---|---|---|---|---|
| Teva Pharmaceuticals USA, Inc. |
Food and Beverage
In-kind items and services
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AUSTEDO XR | General | $13.49 |
Source: CMS Open Payments, program year 2025, released June 30, 2026.
Performed Procedures & Service Volume
CPTยฎ is a registered trademark of the American Medical Association. CPT codes, descriptions and other data only are copyright 2022โ2023 American Medical Association. All rights reserved. Applicable FARS/HHSARS apply. Descriptions of CPT codes are the AMA's CPT Consumer Friendly Descriptors as published by CMS in the Medicare Physician & Other Practitioners โ by Provider and Service data, 2023โ2024; they are plain-language summaries, not for clinical coding or documentation. HCPCS Level II codes and descriptions are from CMS. Fee schedules, relative value units, conversion factors and/or related components are not assigned by the AMA, are not part of CPT, and the AMA is not recommending their use. The AMA does not directly or indirectly practice medicine or dispense medical services. The AMA assumes no liability for data contained or not contained herein.
| HCPCS Code | Services | Patients | Submitted Charge | Medicare Allowed |
|---|---|---|---|---|
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99223
Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes
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96 | 90 | $314.60 | $136.43 |
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99222
Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes
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71 | 69 | $236.38 | $102.41 |
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99221
Initial hospital care with straightforward or low level of medical decision making, per day, if using time, at least 40 minutes
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68 | 62 | $148.82 | $64.37 |
Source: CMS Part B by Provider and Service, 2024; services under 11 beneficiaries omitted by CMS. Privacy limits
Submitted charges are billed amounts, not a price quote for your visit.
Specialties & License Numbers Reported to NPPES
Self-certified to NPPES: 2023-11-01NUCC Taxonomy Code: 363L00000X
(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.
Medicare (PECOS) Enrollment & Ordering Eligibility
Source: CMS PECOSPRACTITIONER - NURSE PRACTITIONER
I20221202002397
IN
8628447240
Sources: CMS Provider Enrollment and Order and Referring. Medicare enrollment is a billing status, not an accreditation or quality rating.
Medicare Group Practice Enrollments
Source: CMS Doctors and Clinicians National Downloadable File, CMS release of October 2, 2026
Nephrology Associates Of Northern Indiana Pc
11104 Parkview Circle Dr, Fort Wayne, IN 468451674
Phone: 2604943484
Secondary Practice Locations
11104 Parkview Circle Dr Ste 110
Fort Wayne, IN 468451673
Phone: 2604256780
Clinicians Sharing This Practice Address or Phone
Clinicians sharing this NPPES address, phone or fax; a shared contact does not mean they work together.
Internal Medicine - Nephrology
Bachelor of Medicine, Bachelor of Surgery (M.B.B.S.)
Internal Medicine - Nephrology
Doctor of Medicine (M.D.)
Internal Medicine - Nephrology
Doctor of Medicine (M.D.)
Internal Medicine - Nephrology
Doctor of Medicine (M.D.)
Internal Medicine - Nephrology
Doctor of Medicine (M.D.)
Internal Medicine - Nephrology
Doctor of Medicine (M.D.)
Career & Practice History Timeline
Changes recorded in monthly NPPES data files: addresses, names, credentials, specialties and NPI status
Registered at 11104 PARKVIEW CIRCLE DR STE 330, FORT WAYNE, IN 468451674 (Tel: 2604943484)
Registered at 120 W 22ND ST STE 200, OAK BROOK, IL 605231563 (Tel: 6305735000)
Additional practice office at 11104 Parkview Circle Dr Ste 110, Fort Wayne, IN 468451673
Nurse Practitioner (license number reported to NPPES: IN 71012742A)
Registered at 11104 PARKVIEW CIRCLE DR STE 110, FORT WAYNE, IN 468451673 (Tel: 2604256780)
NPI status registered as active in NPPES database
Registered at 11109 PARKVIEW PLAZA DR # 117, FORT WAYNE, IN 468451701 (Tel: 2602661000)
Registered at 11109 PARKVIEW PLAZA DR # 117, FORT WAYNE, IN 468451701 (Tel: 2602661000)
Recorded as JACOB SHIVELY
Registered Nurse (license number reported to NPPES: IN 28231566A)
First registered as active Individual Practitioner in NPPES Database.
NPI Administrative Meta
Other Nurse Practitioners in Fort Wayne
- Amanda Ringwood
- Cinamon Donley, NP-C
- Kerrick Mathis
- Amanda Macias
- Stephanie Trice, FNP
- Malin Adams, AGPCNP-BC
Mailing Address
120 W 22nd St Ste 200
Oak Brook, IL 605231563
Phone: 6305735000