SHANE UDELHOVEN (PA-C) – Medical Physician Assistant, NPI 1124355359
Medical Physician Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
551 PHYSICIAN ASSISTANT in AK
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Provider Addresses for SHANE UDELHOVEN (PA-C)
48690 TOTE RD
SOLDOTNA, AK 996699155
Phone:
Type: Mailing
Kenai Spur Highway, Soldotna, Kenai Peninsula, Alaska, United States
SOLDOTNA, AK 996697649
Phone: (907) 260-1655
Fax: (980) 495-8870
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 7 Open Payments records for all available years, with a total value of $145.
Total Amount is formed as General ($145) + Research ($0) + Ownership ($0) = $145.
Last reported payment date: 2024-08-29 • Largest payer in this snapshot: ABBVIE INC. ($80).
Total Amount
$145
General + Research + Ownership
Payments
7
Total payment records
General Amount
$145
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-08-29
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| ABBVIE INC. | $80 |
| Amgen Inc. | $27 |
| Novo Nordisk Inc | $20 |
| Lilly USA, LLC | $17 |
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2010-05-25
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20100525001036 | I | Physician Assistant | AK | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 79 | 48 | $0 |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 59 | 30 | $0 |
| G0439 | Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit | 21 | 21 | $0 |
Insurance plans in this area (ZIP 99669)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| - | AK | |
| Nurse Practitioner | AK |
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