Jacob Tyler Shreve, MD

Primary specialty

Hematology & Oncology PhysicianTaxonomy code 207RH0003X

License

69855 Issued in MN

Practice address

200 1St Street SW
Rochester, MN 55905

Phone

(507) 284-2511

NPI assigned

Apr 23, 2018

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in HI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Hematology/Oncology

Education

University of Louisville School of Medicine, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Castle Medical CenterGroup PAC ID 6608762778, 77 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Adventist Health Home Care Services Home health agency, Kaneohe, HI, CCN 127017
• Adventist Health Castle Hospital, Kailua, HI, CCN 120006
• Kuakini Medical Center Hospital, Honolulu, HI, CCN 120007
• Kahuku Medical Center Hospital, Kahuku, HI, CCN 121304

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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

• Castle Medical Center

  • General Acute Care Hospital
  • Kailua, HI
  • NPI 1316937691

  Multi-Specialty

  Medicare reassignment Care Compare group NPD
• Castle Medical Center

  • Community/Retail Pharmacy
  • Kaneohe, HI
  • NPI 1679540264
  NPD
• Castle Medical Center

  • Clinic/Center
  • Kailua, HI
  • NPI 1710336011

  Multi-Specialty

  NPD

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

• Castle Medical Center

  • General Acute Care Hospital
  • Kailua, HI
  • NPI 1316937691
  Care Compare affiliation
• Kahuku Medical Center

  • Critical Access Hospital
  • Kahuku, HI
  • NPI 1245430065
  Care Compare affiliation
• Kuakini Medical Center

  • General Acute Care Hospital
  • Honolulu, HI
  • NPI 1215939335
  Care Compare affiliation
• Western Health Resources

  • Home Health Agency
  • Kaneohe, HI
  • NPI 1093147886
  Care Compare affiliation

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

{
    "created_epoch": "1524441600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627862400000",
    "number": "1497242713",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 1ST STREET SW",
            "city": "ROCHESTER",
            "state": "MN",
            "postal_code": "55905",
            "telephone_number": "507-284-2511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 1ST STREET SW",
            "city": "ROCHESTER",
            "state": "MN",
            "postal_code": "55905",
            "telephone_number": "507-284-2511"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "Cleveland Clinic 9500 Euclid Avenue/Na- 23",
            "address_purpose": "LOCATION",
            "city": "Cleveland",
            "state": "OH",
            "postal_code": "441950001",
            "country_code": "US",
            "telephone_number": "216-444-2200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHREVE",
        "first_name": "JACOB",
        "middle_name": "TYLER",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-04-23",
        "last_updated": "2021-08-02",
        "certification_date": "2021-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "OH",
            "license": "57.246767",
            "primary": false
        },
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "MN",
            "license": "69855",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jshreve1425298@ehrdirect.mayoclinicmsg.org",
            "affiliation": "N",
            "address_1": "200 1st Street SW",
            "city": "Rochester",
            "state": "MN",
            "country_code": "US",
            "postal_code": "55905",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Amber Showalter
• Anna Elizabeth Showalter, PHARMD, MBA
• Gyaneswhor Shrestha, MD
• Malakh Lal Shrestha, MBBS, PHD
• Raslina Shrestha, MBBS
• Heidi Shriver
• Sara Marianna Shu, DO
• Clarence Shub, M.D.
• Lois L.a. Shub, L.P.
• Terry A Shubert, PT

• Hematology & Oncology Physician in Rochester, MN
• Providers in Rochester, MN by specialty
• Hematology & Oncology Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.