NPIMap

Individual provider Active NPI

Jacob T Shelsy, PA-C

  • Physician Assistant
  • Williamstown, MA
National Provider Identifier
1417346974
Registry record updated May 14, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA5187 Issued in MA
Practice address
197 Adams Road
Williamstown, MA 01267
Phone
(413) 458-8182
Fax
(413) 458-3140
NPI assigned
Jan 21, 2015
Last updated
May 14, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 14, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA5187 MA Primary

Addresses

Primary practice location

197 Adams Road
Williamstown, MA 01267

Mailing address

197 Adams Road
Williamstown, MA 01267-2930
Phone (413) 458-8182

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150320001274 MA Practitioner - Physician Assistant 4082931563 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fairview HospitalGroup PAC ID 1254240773, 56 clinicians
Berkshire Faculty Services IncGroup PAC ID 8224068424, 276 clinicians

Practice addresses (Care Compare)

197 Adams Rd
Williamstown, MA 01267-2930
Phone (413) 458-3140

71 Hospital Ave
North Adams, MA 01247-2504
Phone (413) 664-5710

777 N St
Suite 207
Pittsfield, MA 01201-4123
Phone (413) 499-8510

780 S Main St
Suite 2
Great Barrington, MA 01230-2149
Phone (413) 447-2498

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA5187MAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Fairview Hospital CurrentSince Feb 1, 2020 Accepting new patients
Fairview Hospital Current Accepting new patients
Fairview Hospital CurrentSince Jul 12, 2016 Accepting new patients
Fairview Hospital CurrentSince Feb 1, 2020 Accepting new patients
Fairview Hospital Past Accepting new patients

Locations

29 Lewis Ave
Gt Barrington, MA 01230
Phone (413) 528-0790

780 S Main St
Ste 2
Gt Barrington, MA 01230
Phone (413) 447-2498

77 Hospital Ave
Ste 300
North Adams, MA 01247
Phone (413) 664-5959

725 North St
Pittsfield, MA 01201
Phone (413) 447-2839

197 Adams Rd
Williamstown, MA 01267
Phone (413) 458-8182

197 Adams Rd
#A
Williamstown, MA 01267

Interoperability endpoints

  • Direct secure messaging: jacobshelsy@fvh.medalliesdirect.net

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 9

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1421798400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1526256000000",
    "number": "1417346974",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "197 ADAMS ROAD",
            "city": "WILLIAMSTOWN",
            "state": "MA",
            "postal_code": "012672930",
            "telephone_number": "413-458-8182",
            "fax_number": "413-458-3140"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "197 ADAMS ROAD",
            "city": "WILLIAMSTOWN",
            "state": "MA",
            "postal_code": "01267",
            "telephone_number": "413-458-8182",
            "fax_number": "413-458-3140"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHELSY",
        "first_name": "JACOB",
        "middle_name": "T",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-01-21",
        "last_updated": "2018-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MA",
            "license": "PA5187",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Williamstown, MA

Sources for this page

Verify at the official NPI Registry.