Individual provider Active NPI

Jeffrey S Shelby, MD

  • Specialist
  • Plattsburgh, NY
National Provider Identifier
1962437392
Registry record updated Aug 17, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
257161 Issued in NY
Practice address
4 Monty St
Plattsburgh, NY 12901-3729
Phone
(774) 404-4420
NPI assigned
Jul 12, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 17, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 257161 NY Primary

Addresses

Primary practice location

4 Monty St
Plattsburgh, NY 12901-3729

Mailing address

4 Monty St
Plattsburgh, NY 12901-3729
Phone (774) 404-4420

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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

Enrollment IDStateProvider typePAC IDDetails
I20110422000450 NY Practitioner - Internal Medicine 9335324052 Practice locations: Plattsburgh, NY

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
G054026CAMDSpecialist
257161NYMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Loyola Recovery Foundation, Inc. Current Accepting new patients
On Call Medical Services Assoc. LLP Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: jshelby@direct.loyolarecovery.org

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1152662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786924800000",
    "number": "1962437392",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 MONTY ST",
            "city": "PLATTSBURGH",
            "state": "NY",
            "postal_code": "129013729",
            "telephone_number": "774-404-4420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 MONTY ST",
            "city": "PLATTSBURGH",
            "state": "NY",
            "postal_code": "129013729",
            "telephone_number": "774-404-4420"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHELBY",
        "first_name": "JEFFREY",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-12",
        "last_updated": "2026-08-17",
        "certification_date": "2026-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NY",
            "license": "257161",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plattsburgh, NY

Sources for this page

Verify at the official NPI Registry.