Shane Saji Jacob , PA
Physician Assistant โข Elmhurst, NY
7901 Broadway
Elmhurst, NY 113731329
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 July 17, 2020; this date does not establish years in practice.
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Published CMS data list 1,041 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:
- 99213 โ Established patient outpatient office visit: 334 service units.
- 87811 โ Detection test by immunoassay with direct visual observation for severe acute respiratory syndrome coronavirus 2 (covid-19): 236 service units.
- 87804 โ Detection test by immunoassay with direct visual observation for influenza virus: 184 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 all 10 records in the table ยท Guide: How to read Medicare Part B data
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Published CMS data list 551 Medicare Part D prescriptions, including refills, in 2024.
Source: CMS, Medicare Part D Prescribers โ by Provider and Drug, 2024. Published rows only; this is not a quality measure.
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Published Part D records, 2024:
- Azithromycin โ 70 prescription fills, including refills.
- Prednisone โ 50 prescription fills, including refills.
- Fluticasone Propionate โ 50 prescription fills, including refills.
Source: CMS, Medicare Part D Prescribers โ by Provider and Drug, 2024. Drug names come from pharmacy claims. Listing a drug here is not an endorsement or a recommendation.
See all 22 records in the table ยท Guide: How to read Medicare Part D prescriber data
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More Medicare Part B services than 95% of clinicians listed under Physician Assistant in Elmhurst, NY (2024, 22 clinicians with data). Median for this group: 170. Middle half: 77 to 325.
More Medicare Part B services than 90% of clinicians listed under Physician Assistant in New York (2024, 5,025 clinicians with data). Median for this group: 151. Middle half: 53 to 410.
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 1,733 in 2022 to 1,041 in 2024.
Source: CMS, Medicare Physician & Other Practitioners โ by Provider and Service, 2022โ2024.
Practice Location & Contact Primary Location
7901 Broadway
Elmhurst, NY 113731329
Matched by practice address or phone in NPPES. A shared address or phone does not confirm that this clinician works there.
CMS Doctors and Clinicians lists 1 group name: Divinity Medical Services Pllc. See the list
Source: CMS Doctors and Clinicians National Downloadable File, release date unavailable.
Listings do not confirm current availability, employment or a shared ownership network.
Medicare Profile & Education
Source: CMS Doctors and Clinicians National Downloadable File
2020
What Public CMS Data Show
Physician Assistant: NPPES taxonomy is a reported classification, not proof of board certification.
Medicare patients
447 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 $66,941 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 $48,535 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.
30-day fills
568 standardized 30-day fills in 2024
CMS converts prescriptions to 30-day supplies so they can be compared. A 90-day prescription counts as about three 30-day fills.
What this does not show: 30-day fills
It is not a count of patients and not a measure of quality.
Part D drug cost
$6,581 in 2024
The total cost of these prescriptions in 2024, paid by Medicare drug plans, patients and other payers together.
It shows the total spending on drugs this clinician prescribed, not what any one patient paid.
What this does not show: Part D drug cost
A higher cost often reflects the type of medicines a specialty uses. It is not your out-of-pocket cost and not a measure of quality.
Source: CMS, Medicare Part D Prescribers โ by Provider and Drug, 2024.
Industry payments (Open Payments)
No Open Payments records are listed for this clinician for 2021โ2025.
Years since graduation
6 years (graduated 2020)
CMS Doctors and Clinicians data list 2020 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.
NPI first issued
2020
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; 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.
Enrolled in Medicare (PECOS)
Shane Jacob 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 Shane Jacob 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 Elmhurst and New York
Billing and prescribing volume is not a quality rating.
Medicare Part B services
More Medicare Part B services than 95% of clinicians listed under Physician Assistant in Elmhurst, NY (2024, 22 clinicians with data). Median for this group: 170. Middle half: 77 to 325.
More Medicare Part B services than 90% of clinicians listed under Physician Assistant in New York (2024, 5,025 clinicians with data). Median for this group: 151. Middle half: 53 to 410.
Medicare-allowed amount
A higher Medicare-allowed amount than 85% of clinicians listed under Physician Assistant in Elmhurst, NY (2024, 22 clinicians with data). Median for this group: $14,528. Middle half: $6,256 to $26,843.
A higher Medicare-allowed amount than 90% of clinicians listed under Physician Assistant in New York (2024, 5,025 clinicians with data). Median for this group: $12,004. Middle half: $4,378 to $28,196.
Paid by Medicare
A higher Medicare payment amount than 90% of clinicians listed under Physician Assistant in Elmhurst, NY (2024, 22 clinicians with data). Median for this group: $11,062. Middle half: $4,406 to $21,163.
A higher Medicare payment amount than 90% of clinicians listed under Physician Assistant in New York (2024, 5,025 clinicians with data). Median for this group: $8,890. Middle half: $3,209 to $20,987.
Medicare Part D prescriptions
More Part D prescriptions than 75% of clinicians listed under Physician Assistant in Elmhurst, NY (2024, 50 clinicians with data). Median for this group: 198. Middle half: 45 to 486.
More Part D prescriptions than 70% of clinicians listed under Physician Assistant in New York (2024, 6,800 clinicians with data). Median for this group: 172. Middle half: 46 to 640.
Part D drug cost
Close to the middle for clinicians listed under Physician Assistant in Elmhurst, NY (2024, 50 clinicians with data). Median for this group: $2,757. Middle half: $560 to $33,772.
Close to the middle for clinicians listed under Physician Assistant in New York (2024, 6,800 clinicians with data). Median for this group: $2,860. Middle half: $381 to $63,975.
146 active clinicians are listed under Physician Assistant with a practice address in Elmhurst, NY (15,558 in New York).
Addresses are self-reported to NPPES and may be out of date.
Telehealth indicator in Elmhurst
3.4% of these 146 clinicians have the CMS telehealth indicator.
35.6% of these 146 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 decreased 40% from 1,733 in 2022 to 1,041 in 2024.
- 2022: 1,733
- 2023: 1,044
- 2024: 1,041
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Medicare-allowed amount
Medicare-allowed amount decreased 44% from $119,485 in 2022 to $66,941 in 2024.
- 2022: $119,485
- 2023: $68,114
- 2024: $66,941
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Paid by Medicare
Paid by Medicare decreased 58% from $115,567 in 2022 to $48,535 in 2024.
- 2022: $115,567
- 2023: $54,968
- 2024: $48,535
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Medicare Part D prescriptions
Medicare Part D prescriptions increased 296% from 139 in 2022 to 551 in 2024.
- 2022: 139
- 2023: 300
- 2024: 551
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30-day fills
30-day fills increased 309% from 139 in 2022 to 568 in 2024.
- 2022: 139
- 2023: 315
- 2024: 568
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Part D drug cost
Part D drug cost increased 482% from $1,131 in 2022 to $6,581 in 2024.
- 2022: $1,131
- 2023: $2,552
- 2024: $6,581
Sources: CMS Medicare Physician & Other Practitioners (2024), CMS Medicare Part D Prescribers (2024), CMS Doctors and Clinicians, CMS NPPES NPI Registry. Specialty names follow the NUCC Health Care Provider Taxonomy.
Text: T-MedInfo ยท Report an error.
Performed Procedures & Service Volume
CPTยฎ is a registered trademark of the American Medical Association. CPT codes, descriptions and other data only are copyright 2021โ2023 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, 2022โ2024; 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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99213
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more
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334 | 281 | $210.85 | $87.72 |
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87811
Detection test by immunoassay with direct visual observation for severe acute respiratory syndrome coronavirus 2 (covid-19)
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236 | 222 | $82.76 | $40.03 |
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87804
Detection test by immunoassay with direct visual observation for influenza virus
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184 | 92 | $49.84 | $15.87 |
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99214
Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more
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107 | 105 | $220.00 | $122.39 |
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99203
New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more
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62 | 62 | $211.61 | $108.40 |
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81003
Automated urinalysis test
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32 | 28 | $4.62 | $2.20 |
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87880
Detection test by immunoassay with direct visual observation for streptococcus, group a (strep)
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32 | 31 | $33.94 | $15.69 |
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99204
New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more
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28 | 28 | $291.06 | $161.97 |
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93000
Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report
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14 | 14 | $30.75 | $14.08 |
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87807
Detection test by immunoassay with direct visual observation for respiratory syncytial virus
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12 | 12 | $17.99 | $12.84 |
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.
Medicare Part D Prescribing Profile & Medications
Medicare Part D prescriptions filled, including refills, in 2024.
| Brand Name | Generic Name | Prescriptions | Day Supply | Total Cost | Patients |
|---|---|---|---|---|---|
| Azithromycin | Azithromycin | 70 | 352 | $249.65 | 68 |
| Prednisone | Prednisone | 50 | 251 | $117.19 | 47 |
| Fluticasone Propionate | Fluticasone Propionate | 50 | 1,795 | $515.41 | 49 |
| Ibuprofen | Ibuprofen | 47 | 350 | $115.85 | 43 |
| Cephalexin | Cephalexin | 33 | 231 | $254.11 | 30 |
| Nitrofurantoin Mono-Macro | Nitrofurantoin Monohyd/M-Cryst | 33 | 165 | $202.52 | 28 |
| Ofloxacin | Ofloxacin | 28 | 600 | $520.75 | 28 |
| Sulfamethoxazole-Trimethoprim | Sulfamethoxazole/Trimethoprim | 22 | 161 | $57.09 | 22 |
| Hydrocortisone | Hydrocortisone | 21 | 363 | $136.91 | 20 |
| Paxlovid | Nirmatrelvir/Ritonavir | 20 | 100 | $1,429.40 | 20 |
| Amoxicillin | Amoxicillin | 19 | 145 | $40.75 | 19 |
| Albuterol Sulfate Hfa | Albuterol Sulfate | 19 | 516 | $551.81 | 17 |
| Ciprofloxacin Hcl | Ciprofloxacin Hcl | 18 | 129 | $96.16 | 17 |
| Cyclobenzaprine Hcl | Cyclobenzaprine Hcl | 16 | 170 | $21.09 | 16 |
| Azelastine Hcl | Azelastine Hcl | 15 | 477 | $444.91 | 14 |
| Fluconazole | Fluconazole | 14 | 61 | $56.74 | 12 |
| Ondansetron Odt | Ondansetron | 14 | 79 | $58.52 | 13 |
| Mupirocin | Mupirocin | 14 | 158 | $66.64 | 13 |
| Amoxicillin-Clavulanate Potass | Amoxicillin/Potassium Clav | 13 | 121 | $93.49 | 13 |
| Doxycycline Hyclate | Doxycycline Hyclate | 12 | 94 | $74.49 | 12 |
| Oseltamivir Phosphate | Oseltamivir Phosphate | 12 | 60 | $311.76 | 12 |
| Ciprofloxacin-Dexamethasone | Ciprofloxacin Hcl/Dexameth | 11 | 121 | $1,166.24 | 11 |
Source: CMS Part D by Provider and Drug, 2024; rows below 11 claims omitted by CMS; volume isn’t quality. Privacy limits
Specialties & License Numbers Reported to NPPES
Self-certified to NPPES: 2021-02-26NUCC Taxonomy Code: 363A00000X
A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.
NUCC Taxonomy Code: 363A00000X
A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.
Medicare (PECOS) Enrollment & Ordering Eligibility
Source: CMS PECOSPRACTITIONER - PHYSICIAN ASSISTANT
I20210312001472
NY
8820404098
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
Divinity Medical Services Pllc
3379 Crompond Rd, Yorktown Heights, NY 105983605
Phone: 9149305550
Divinity Medical Services Pllc
2128 Rockaway Pkwy, Brooklyn, NY 112365802
Phone: 7184898820
Divinity Medical Services Pllc
1585 Dutch Broadway, Valley Stream, NY 115801333
Phone: 5164906300
Divinity Medical Services Pllc
464 Atlantic Ave, East Rockaway, NY 115181415
Phone: 5167303344
Divinity Medical Services Pllc
3400 Boston Rd, Bronx, NY 104692502
Phone: 7182908787
Divinity Medical Services Pllc
23315 Hillside Ave, Queens Village, NY 114272634
Phone: 7182101945
Clinicians Sharing This Practice Address or Phone
Clinicians sharing this NPPES address, phone or fax; a shared contact does not mean they work together.
Physician Assistant
Physician Assistant
Physician Assistant
Career & Practice History Timeline
Changes recorded in monthly NPPES data files: addresses, names, credentials, specialties and NPI status
Registered at 7901 BROADWAY, ELMHURST, NY 113731329 (Tel: 7183342480)
Registered at 7901 BROADWAY, ELMHURST, NY 113731329 (Tel: 7183342480)
Registered at 5707 S CASS AVE, WESTMONT, IL 605594800 (Tel: 0000000000)
NPI status registered as active in NPPES database
Registered at 18W194 CLAREMONT DR, DARIEN, IL 605613640 (Tel: 6305060983)
Registered at 18W194 CLAREMONT DR, DARIEN, IL 605613640 (Tel: 6305060983)
Recorded as SHANE JACOB, PA
Physician Assistant
First registered as active Individual Practitioner in NPPES Database.
NPI Administrative Meta
Other Physician Assistants in Elmhurst
- Nazma Akhter, PA-C
- Obed Flores, PA-C
- Emmanuel Agnant, PA
- Emily Wu, PA
- Fabiola Plaza, PA
- Dorit Bamshad, PA-C
Mailing Address
7901 Broadway
Elmhurst, NY 113731329
Phone: 7183342480