DR. JORDAN TYLER SHIVELY D.O.
NPI 1194170910
Surgery in Las Vegas, NV

NPI Status: Active since April 29, 2016

Contact Information

8930 W SUNSET RD STE 300
LAS VEGAS, NV
ZIP 89148
Phone: (702) 228-8834

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  • Individual
  • Male
  • Years of Experience 10
  • Surgery
  • Accepts Insurance
  • Accepts Medicare Approved Payment
  • PECOS Enrolled

About JORDAN SHIVELY

This page provides the complete NPI Profile along with additional information for Jordan Shively, a provider established in Las Vegas, Nevada with a medical specialization in Surgery and more than 10 years of experience. The healthcare provider is registered in the NPI registry with number 1194170910 assigned on April 2016. The practitioner's primary taxonomy code is 208600000X with license number DO2821 (NV). The provider is registered as an individual and his NPI record was last updated 4 years ago.

NPI
1194170910
Provider Name
DR. JORDAN TYLER SHIVELY D.O.
Gender
Male
Entity Type
Individual
Location Address
8930 W SUNSET RD STE 300 LAS VEGAS, NV 89148
Location Phone
(702) 228-8834
Mailing Address
8930 W SUNSET RD STE 300 LAS VEGAS, NV 89148
Mailing Phone
(702) 228-8834
Medical School Name
OTHER
Graduation Year
2016
Is Sole Proprietor?
No
Enumeration Date
04-29-2016
Last Update Date
07-01-2021
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A surgeon like Jordan Shively treats injuries, diseases, and deformities through surgical operations. A surgeon could correct physical deformities, repair bone and tissue, or perform preventive or elective surgeries. Surgeons also examine patients, perform and interpret diagnostic tests, and provide counsel on preventive healthcare.

Location Map

Secondary Locations

  • 20000 Harvard Ave
    Warrensville Heights, OH 44122
    (216) 491-7464

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Surgery

Taxonomy Code
208600000X
Type
Allopathic & Osteopathic Physicians
License No.
DO2821
License State
NV
Taxonomy Description
A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery.

Secondary Taxonomies

The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.

No. Taxonomy Code Type Classification /
Specialization
License No. (State)
1390200000XStudent, Health Care

Student in an Organized Health Care Education/Training Program

(OH)

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

  • Choice Bronze HSA - HMO
  • Choice Bronze HSA + Vision + Adult Dental - HMO
  • Clear Silver - HMO
  • Complete Gold - HMO
  • Complete Gold + Vision + Adult Dental - HMO
  • Complete Silver - HMO
  • Complete Silver + Vision + Adult Dental - HMO
  • Elite Gold - HMO
  • Elite Gold + Vision + Adult Dental - HMO
  • Everyday Bronze - HMO
  • Everyday Bronze + Vision + Adult Dental - HMO
  • Standard Expanded Bronze - HMO
  • Standard Expanded Bronze + Vision + Adult Dental - HMO
  • Standard Gold - HMO
  • Standard Gold + Vision + Adult Dental - HMO
  • Standard Silver - HMO
  • Standard Silver + Vision + Adult Dental - HMO
  • Clear VALUE Silver - HMO
  • Complete VALUE Gold - HMO
  • Focused VALUE Silver - HMO
  • Focused VALUE Silver + Vision + Adult Dental - HMO
  • Standard Gold VALUE - HMO
  • Standard Silver VALUE - HMO
  • Standard Silver VALUE + Vision + Adult Dental - HMO
  • Complete VALUE Gold - HMO
  • Complete VALUE Silver - HMO
  • Elite VALUE Bronze - HMO
  • Focused VALUE Silver - HMO
  • Standard Expanded Bronze VALUE - HMO
  • Standard Gold VALUE - HMO
  • Standard Silver VALUE - HMO

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Medicare Participation & PECOS Enrollment Status

Jordan Shively is registered with Medicare and accepts claims assignment, this means the provider accepts the approved amount for the cost of rendered services as full payment. Participating providers may not charge beneficiaries more than the approved amount for their services. Please keep in mind that beneficiaries still have to pay a coinsurance or copayment amount for a visit or service.

Jordan Shively is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.

What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.

  • Is the provider registered in PECOS? Yes

  • PECOS PAC ID: 5698067189

    What is the PECOS Associate Control ID?
    A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.

  • PECOS Enrollment ID: I20210929001997

    What is the Provider Enrollment ID?
    The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.

  • Accepts Medicare Assignment? Yes

    What does it mean "accepts medicare assignment"?
    When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
    A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.

  • Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes

  • Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes

  • Eligible to Order or Refer a Home Health Agency (HHA): Yes

  • Eligible to Order or Refer Power Mobility Devices: Yes

Areas of Expertise

The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.

Colonoscopy

A colonoscopy is a medical procedure that allows your doctor to examine your colon (the large intestine). It utilizes a thin, flexible tube with a tiny camera on the end, which is inserted through the rectum. This procedure can help identify issues such as polyps, inflammation, or early signs of cancer. It's usually recommended for people over 50 or those with specific risk factors.

This service was performed for 67 patients

Follow-up hospital inpatient care per day, typically 15 minutes

Follow-up hospital inpatient care is a daily service where a healthcare professional checks on your health progress during your hospital stay. Each session typically lasts 15 minutes, involving updates on your condition and adjustments to your treatment plan, if necessary.

This service was performed 29 times for 23 patients

Hernia repair - groin (open)

Hernia repair in the groin area (open) is a surgical procedure to fix a bulge or protrusion, caused by internal tissues pushing through a weak spot in your abdominal wall. In this operation, a small incision is made in the groin area. The protruding tissue is then placed back into the abdomen, and the weakened area is reinforced with stitches or a mesh.

This service was performed for 1-10 patients

Hernia repair (minimally invasive)

Hernia repair is a surgery to fix a hernia - a condition where an organ pushes through an opening in the muscle or tissue that holds it in place. Minimally invasive hernia repair involves small incisions, a tiny camera, and special surgical tools. This method often leads to quicker recovery, less pain, and reduced scarring compared to traditional surgery.

This service was performed for 36 patients

Initial hospital inpatient care per day, typically 50 minutes

Initial hospital inpatient care is a service where a healthcare provider spends about 50 minutes per day overseeing your care while you're admitted in the hospital. This includes reviewing your health status, planning your treatment, and ensuring your safety and comfort.

This service was performed 17 times for 17 patients

New patient office or other outpatient visit, 30-44 minutes

This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.

This service was performed 54 times for 54 patients

New patient office or other outpatient visit, 45-59 minutes

This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.

This service was performed 13 times for 13 patients

Removal of gallbladder with x-ray study of bile ducts using an endoscope

This procedure, known as an endoscopic retrograde cholangiopancreatography (ERCP), involves using a flexible camera (endoscope) to examine your bile ducts. If gallstones are found, your gallbladder may be removed in a separate procedure. This helps prevent future complications.

This service was performed 13 times for 13 patients

Upper gastrointestinal (GI) endoscopy for acid reflux

An upper GI endoscopy is a procedure to examine your esophagus and stomach using a thin, flexible tube called an endoscope. It helps diagnose conditions like acid reflux by identifying any inflammation or damage. It's generally safe, performed under sedation, and takes about 15-30 minutes.

This service was performed for 32 patients

Varicose vein removal

Varicose vein removal is a procedure to eliminate enlarged and twisted veins, commonly found in legs. It's performed when these veins cause discomfort or skin problems. The procedure may involve laser treatment, sclerotherapy (injecting a solution to close the veins), or surgery to remove the veins. It's generally safe and helps to alleviate symptoms.

This service was performed for 1-10 patients

Physician Visit Costs



The typical physician office visit costs for Medicare beneficiaries in this area are: $22.12 for a new patient copayment and $17.78 for an established patient copayment.

The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.

For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.

The prices below reflect the costs for new and established patients in the 89148 ZIP code area.

New Patients Visit Costs *

The most utilized procedure code for new patients office visits is 99203

  • Average New Patient Price $88.51
  • Minimum New Patient Price $57.07
  • Maximum New Patient Price $173.24
  • Average New Patient Copayment $22.12
  • Minimum New Patient Copayment $14.26
  • Maximum New Patient Copayment $43.31

Established Patients Visit Costs *

The most utilized procedure code for established patients office visits is 99213

  • Average Established Patient Price $71.14
  • Minimum Established Patient Price $18.27
  • Maximum Established Patient Price $140.96
  • Average Established Patient Copayment $17.78
  • Minimum Established Patient Copayment $4.56
  • Maximum Established Patient Copayment $35.24

* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.

Find Provider Hospital Affiliations - Privileges

Doctors and physicians must apply for hospital privileges to treat patients at hospitals. Find out if your doctor has privileges to practice at your preferred hospital by using the hospital affiliation information below based on recent medical claims.

Hospital affiliation is identified through self-reporting data, inpatient, outpatient, physician and ancillary service claims linked by the medical claims NPI number and place of service code. Additionally, to further determine provider hospital affiliation the clinician must have provided services to at least three patients on three different dates in the last 12 months. Jordan Shively is affiliated with the following medical facilities:

Hospital Name Address Phone Hospital Type Overall Rating
VALLEY HOSPITAL MEDICAL CENTER620 SHADOW LANE
LAS VEGAS, NV 89106
(702) 388-4000Acute Care Hospitals
SUMMERLIN HOSPITAL MEDICAL CENTER657 TOWN CENTER DRIVE
LAS VEGAS, NV 89144
(702) 233-7500Acute Care Hospitals
SAINT ROSE DOMINICAN HOSPITALS - SIENA CAMPUS3001 ST ROSE PARKWAY
HENDERSON, NV 89052
(702) 616-5000Acute Care Hospitals
SAINT ROSE DOMINICAN HOSPITALS - SAN MARTIN CAMPUS8280 W WARM SPRINGS ROAD
LAS VEGAS, NV 89113
(702) 492-8509Acute Care Hospitals
DESERT VIEW HOSPITAL360 SOUTH LOLA LANE
PAHRUMP, NV 89048
(775) 751-7500Critical Access Hospitals

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NPI Validation Check Digit Calculation


The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.

Start with the original NPI number, the last digit is the check digit and is not used in the calculation.
1194170910
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
2118427092
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 1 + 1 + 8 + 4 + 2 + 7 + 0 + 9 + 2 + 24 = 60
Step 3: because the number obtained in step 2 ends in zero, the check digit is zero.
0

The NPI number 1194170910 is valid because the calculated check digit 0 using the Luhn validation algorithm matches the last digit of the original NPI number.

Other Providers at the Same Location


The following 14 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1043364532 EDDY H LUH M.D.,
Individual
Surgery (Vascular Surgery)8930 W SUNSET RD STE 300
LAS VEGAS, NV 89148
(702) 258-7788
1760611339DR. DAMON THOMAS SCHROER M.D.
Individual
Surgery8930 W SUNSET RD STE 300
LAS VEGAS, NV 89148
(702) 258-7788
1366916082 ANDREA ABALONI EGHTERAFI PA-C
Individual
Physician Assistant (Surgical)8930 W SUNSET RD STE 300
LAS VEGAS, NV 89148
(702) 258-7788
1992704985 ARTHUR ARNALDO FUSCO MD
Individual
Surgery8930 W SUNSET RD STE 300
LAS VEGAS, NV 89148
(702) 258-7788
1861786329DR. JIASHOU J XU M.D.
Individual
Surgery8930 W SUNSET RD STE 300
LAS VEGAS, NV 89148
(702) 258-7788
1659994143 KAITLYN M CHOY
Individual
Nurse Practitioner8930 W SUNSET RD STE 300
LAS VEGAS, NV 89148
(702) 258-7788
1417685983LV SURGERY ASSOCIATES PLLC
Organization
Thoracic Surgery (Cardiothoracic Vascular Surgery)8930 W SUNSET RD STE 300
LAS VEGAS, NV 89148
(702) 258-7788
1891403952LVSA ON CALL PLLC
Organization
Surgery (Vascular Surgery)8930 W SUNSET RD STE 300
LAS VEGAS, NV 89148
(702) 258-7788
1710220421DR. ROY CHRISTIAN GAN MD
Individual
Surgery8930 W SUNSET RD STE 300
LAS VEGAS, NV 89148
(702) 258-7788
1013407642 COLTON TY LEE MD
Individual
Surgery8930 W SUNSET RD STE 300
LAS VEGAS, NV 89148
(702) 757-4724
1245750876DR. HASSAN RAZA HASHMI MD
Individual
Surgery8930 W SUNSET RD STE 300
LAS VEGAS, NV 89148
(702) 258-7788
1598255341DR. ANGEL JESUS RIVERA APONTE MD
Individual
Surgery8930 W SUNSET RD STE 300
LAS VEGAS, NV 89148
(787) 409-5025
1316488737 JONATHAN CHINO MD
Individual
Surgery8930 W SUNSET RD STE 300
LAS VEGAS, NV 89148
(702) 258-7788
1508681081 ANGELINE MARIE DOMINGO ALAG
Individual
Physician Assistant (Surgical)8930 W SUNSET RD STE 300
LAS VEGAS, NV 89148
(702) 258-7788

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1194170910, enumerated in the NPI registry as an "individual" on April 29, 2016

The provider is located at 8930 W Sunset Rd Ste 300 Las Vegas, Nv 89148 and the phone number is (702) 228-8834

The provider's speciality is Surgery with taxonomy code 208600000X

The provider has more than 10 years of experience.

The provider might be accepting Accepts: Ambetter from Arizona Complete Health, Ambetter. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.

Yes, as of June 20, 2025 the provider is registered in PECOS and is eligible to order health care services or supplies for Medicare patients. If you are a beneficiary the provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.

Medicare beneficiaries should expect a typical cost of $88.51 with an average copayment of $22.12 for new patient appointments. Established patients should expect a typical charge of $71.14 and an average copayment of 17.78. Please review your insurance plan or contact the provider directly to determine your specific costs.

The most common procedures or services performed by this practitioner are: Colonoscopy, Follow-up hospital inpatient care per day, typically 15 minutes, Hernia repair - groin (open), Hernia repair (minimally invasive), Initial hospital inpatient care per day, typically 50 minutes, New patient office or other outpatient visit, 30-44 minutes, New patient office or other outpatient visit, 45-59 minutes, Removal of gallbladder with x-ray study of bile ducts using an endoscope, Upper gastrointestinal (GI) endoscopy for acid reflux and Varicose vein removal.

The practitioner is affiliated to the following hospital(s): VALLEY HOSPITAL MEDICAL CENTER, SUMMERLIN HOSPITAL MEDICAL CENTER, SAINT ROSE DOMINICAN HOSPITALS - SIENA CAMPUS, SAINT ROSE DOMINICAN HOSPITALS - SAN MARTIN CAMPUS and DESERT VIEW HOSPITAL. Hospital affiliations are identified through self-reporting data and service claims based on the place of service.

This NPI record was last updated on April 29, 2016. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
NPI Profile data is regularly updated with the latest NPI registry information, if you would like to update or remove your NPI Profile in this website please contact us.