Dr Jay G Shake, MD - Medicare Thoracic Surgery in Jackson, MS

Dr Jay G Shake, MD is a medicare enrolled "Thoracic Surgery (cardiothoracic Vascular Surgery)" physician in Jackson, Mississippi. He went to University Of Minnesota Medical School and graduated in 1997 and has 27 years of diverse experience with area of expertise as Thoracic Surgery. He is a member of the group practice State Of Mississippi - University Of Mississippi Medical Center and his current practice location is 2500 N State St, Jackson, Mississippi. You can reach out to his office (for appointments etc.) via phone at (601) 984-5100.

Dr Jay G Shake is licensed to practice in Mississippi (license number 23449) and he also participates in the medicare program. He accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1215967500.

Contact Information

Dr Jay G Shake, MD
2500 N State St,
Jackson, MS 39216-4500
(601) 984-5100
Not Available



Physician's Profile

Full NameDr Jay G Shake
GenderMale
SpecialityThoracic Surgery
Experience27 Years
Location2500 N State St, Jackson, Mississippi
Accepts Medicare AssignmentsYes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.
  Medical Education and Training:
  • Dr Jay G Shake attended and graduated from University Of Minnesota Medical School in 1997
  NPI Data:
  • NPI Number: 1215967500
  • Provider Enumeration Date: 07/03/2006
  • Last Update Date: 05/12/2015
  Medicare PECOS Information:
  • PECOS PAC ID: 6507869252
  • Enrollment ID: I20141126000434

Medical Identifiers

Medical identifiers for Dr Jay G Shake such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1215967500NPI-NPPES
693630000MedicaidMN
02358242MedicaidMS

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
2086S0129XSurgery - Vascular Surgery 102316 (Minnesota)Secondary
208G00000XThoracic Surgery (cardiothoracic Vascular Surgery) 23449 (Mississippi)Primary
208G00000XThoracic Surgery (cardiothoracic Vascular Surgery) N8723 (Texas)Secondary
207RC0200XInternal Medicine - Critical Care Medicine N8723 (Texas)Secondary

Medical Facilities Affiliation

Facility NameLocationFacility Type
University Of Mississippi Med CenterJackson, MSHospital

Group Practice Association

Group Practice NameGroup PECOS PAC IDNo. of Members
State Of Mississippi - University Of Mississippi Medical Center1850293036804

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Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Dr Jay G Shake allows following entities to bill medicare on his behalf.
Entity NameState Of Mississippi - University Of Mississippi Medical Center
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1154317527
PECOS PAC ID: 1850293036
Enrollment ID: O20090414000575

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Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Jay G Shake is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Dr Jay G Shake, MD
2500 N State St,
Jackson, MS 39216-4500

Ph: (601) 984-5171
Dr Jay G Shake, MD
2500 N State St,
Jackson, MS 39216-4500

Ph: (601) 984-5100

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Thoracic Surgery (Cardiothoracic Vascular Surgery) Doctors in Jackson, MS

Dr. Richard P Cochran, MD
Thoracic Surgery (Cardiothoracic Vascular Surgery)
Medicare: Medicare Enrolled
Practice Location: 2500 N State St, Jackson, MS 39216
Phone: 406-640-4933    
Dr. Lawrence Lee Creswell, M.D.
Thoracic Surgery (Cardiothoracic Vascular Surgery)
Medicare: Medicare Enrolled
Practice Location: 2500 N State St, Jackson, MS 39216
Phone: 601-984-5170    Fax: 601-984-5198
Dr. Craig Vorpe Adams, M.D.
Thoracic Surgery (Cardiothoracic Vascular Surgery)
Medicare: Accepting Medicare Assignments
Practice Location: 501 Marshall St Ste 104, Jackson, MS 39202
Phone: 601-969-6404    Fax: 601-973-4541
Dr. Ali Dodge-khatami, MD
Thoracic Surgery (Cardiothoracic Vascular Surgery)
Medicare: Medicare Enrolled
Practice Location: 2500 N State St, Division Of Pediatric Cardiac Surgery, Jackson, MS 39216
Phone: 601-984-4693    
Dr. Charles S O'mara, M.D.
Thoracic Surgery (Cardiothoracic Vascular Surgery)
Medicare: Medicare Enrolled
Practice Location: 2500 N State St, Jackson, MS 39216
Phone: 601-984-5105    Fax: 601-815-3322
Dr. Albert Michael Koury, M.D.
Thoracic Surgery (Cardiothoracic Vascular Surgery)
Medicare: Accepting Medicare Assignments
Practice Location: 501 Marshall St, Suite 100, Jackson, MS 39202
Phone: 601-969-7467    Fax: 601-948-1417
Mr. Fidel Fabian Sendra, MD
Thoracic Surgery (Cardiothoracic Vascular Surgery)
Medicare: Accepting Medicare Assignments
Practice Location: 1860 Chadwick Dr Ste 256, Jackson, MS 39204
Phone: 601-376-1394    

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