TARA LYNN SHAFER (FNP) – Family Nurse Practitioner, NPI 1053922641
Family Nurse Practitioner
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
16,360 NURSE PRACTITIONER in CA
Provider Addresses for TARA LYNN SHAFER (FNP)
1350 W 6TH ST STE 200
SAN PEDRO, CA 907323508
Phone: (310) 832-0686
Type: Location
310 N CATALINA AVE UNIT B
REDONDO BEACH, CA 902772830
Phone: (410) 916-8483
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 2 Open Payments records for all available years, with a total value of $51.
Total Amount is formed as General ($51) + Research ($0) + Ownership ($0) = $51.
Last reported payment date: 2023-11-13 • Largest payer in this snapshot: Astellas Pharma US Inc ($51).
Total Amount
$51
General + Research + Ownership
Payments
2
Total payment records
General Amount
$51
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2023-11-13
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Astellas Pharma US Inc | $51 |
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: 2021-01-19
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 |
|---|---|---|---|---|
| I20210119001214 | I | Nurse Practitioner | CA | 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 |
|---|---|---|---|---|
| 96910 | Therapy procedure using ultraviolet radiation with tar or petroleum jelly application | 484 | 33 | $0 |
| 96920 | Treatment of inflammatory skin disease using laser, less than 250.0 sq cm | 242 | 18 | $0 |
| 96922 | Treatment of inflammatory skin disease using laser, more than 500.0 sq cm | 125 | 15 | $0 |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 23 | 12 | $0 |
Insurance plans in this area (ZIP 90732)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Nurse Practitioner | CA | |
| Nurse Practitioner | CA | |
| Nurse Practitioner | CA | |
| Nurse Practitioner | CA | |
| Nurse Practitioner | CA | |
| Nurse Practitioner | CA | |
| Nurse Practitioner | HI | |
| Nurse Practitioner | CA | |
| Nurse Practitioner | CA | |
| - | CA |
Reviews
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