Jacob D. Shank, M.D.

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

49186 Issued in AZ

Practice address

269 S Candy LN
Cottonwood, AZ 86326-4158

Phone

(928) 639-6172

NPI assigned

Mar 22, 2011

Last updated

Aug 20, 2014By the provider in NPPES

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

Medicare fee-for-service enrollment

Enrolled in AZ

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

Emergency Medicine

Education

Tulane University School of Medicine, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Flagstaff Emergency PhysiciansGroup PAC ID 2860380813, 43 clinicians

Emergency Group of Arizona Professional CorporationGroup PAC ID 1355596644, 102 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Verde Valley Medical Center Hospital, Cottonwood, AZ, CCN 030007
• Abrazo Scottsdale Campus Hospital, Phoenix, AZ, CCN 030083
• Abrazo Arrowhead Hospital Hospital, Glendale, AZ, CCN 030094

Merit-based Incentive Payment System (MIPS)

Final score

76.21 of 100Reported as group

Quality

70.63

Improvement activities

40

Merit-based Incentive Payment System (MIPS)

Final score

82.13 of 100Reported as group

Quality

66.85

Promoting interoperability

99

Improvement activities

40

Cost

74.4

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jacob.shank@1099823062319108.direct.elationemr.com

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.

• Emergency Group of Arizona Professional Corporation

  • Emergency Medicine Physician
  • Phoenix, AZ
  • NPI 1215275433
  Medicare reassignment Care Compare group NPD
• Flagstaff Emergency Physicians

  • Emergency Medicine Physician
  • Flagstaff, AZ
  • NPI 1073683991
  Medicare reassignment Care Compare group NPD
• Arizona Acute Medical Services 1 PC

  • Hospitalist Physician
  • Phoenix, AZ
  • NPI 1154860674
  Medicare reassignment NPD
• Sound Physicians Emergency Medicine of Arizona, Inc.

  • Emergency Medicine Physician
  • Sierra Vista, AZ
  • NPI 1700328663
  Medicare reassignment NPD
• Arizona Post-Acute Medical Services 1 PC

  • Hospitalist Physician
  • Phoenix, AZ
  • NPI 1093254419
  NPD (past)
• HCN Ep Horizon City, LLC

  dba The Hospitals of Providence Northeast Campus

  • General Acute Care Hospital
  • El Paso, TX
  • NPI 1861994808
  NPD (past)

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

• Verde Valley Medical Center

  • General Acute Care Hospital
  • Cottonwood, AZ
  • NPI 1346291648
  Care Compare affiliation
• Verde Valley Medical Center

  dba Northern Arizona Healthcare - Sedona

  • General Acute Care Hospital
  • Sedona, AZ
  • NPI 1538608716
  Care Compare affiliation
• VHS Acquisition Subsidiary Number 1 Inc

  dba Abrazo Scottsdale Campus

  • General Acute Care Hospital
  • Phoenix, AZ
  • NPI 1326022732
  Care Compare affiliation
• VHS of Arrowhead, Inc

  dba Abrazo Arrowhead Campus

  • General Acute Care Hospital
  • Glendale, AZ
  • NPI 1326022765
  Care Compare affiliation
• VHS of Arrowhead, Inc.

  dba Abrazo Peoria Emergency Center

  • General Acute Care Hospital
  • Peoria, AZ
  • NPI 1801340781
  Care Compare affiliation

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

{
    "created_epoch": "1300752000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1408492800000",
    "number": "1780983312",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "269 S CANDY LN",
            "city": "COTTONWOOD",
            "state": "AZ",
            "postal_code": "863264158",
            "telephone_number": "928-639-6172"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "269 S CANDY LN",
            "city": "COTTONWOOD",
            "state": "AZ",
            "postal_code": "863264158",
            "telephone_number": "928-639-6172"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHANK",
        "first_name": "JACOB",
        "middle_name": "D.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-03-22",
        "last_updated": "2014-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "AZ",
            "license": "49186",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Richard D Sepela, CRNA
• Serenity Therapeutics LLC.
• Seth Arnall DMD PLLC (Verde River Dental)
• Sabitha Sheela Setty, M.D.
• Ahmed Shah, M.D.
• Janet Elizabeth Shannon, LPC
• Elena Suzanne Shea, MD
• Stephanie Marie Shilling, C.N.M.
• David Clark Shillington, MD
• Isabelle Shook, LPC

• Emergency Medicine Physician in Cottonwood, AZ
• Providers in Cottonwood, AZ by specialty
• Emergency Medicine Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2014; 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.