Preheat oven to 400 F.
In a large bowl, combine the beef, shallot, bread crumbs, oregano, ketchup, egg two tablespoons of the cheese, and red pepper flake (if using). Add a few pinches of salt and pepper.
Heat the oil in a large skillet.
Working in batches, roll the beef into small 1/2" or so round balls (I admit, mine were probably more like an 1" around). You'll make a lot of meatballs.
Add meatballs to the skillet but do not crowd them. Brown on one side, then flip and brown on the other side. Remove to a paper towel-lined plate.
Slowly place all of the meatballs into a dutch oven or other large oven-safe dish.
Add the tomato sauce but do not stir.
Cover and place in the oven for 20-30 minutes.
Meanwhile, cook the pasta per package instructions and drain well.
Remove meatballs from oven and gently stir in the pasta.
Serve with more Parmesan cheese.