KYLIE SHAFFER (FNP-C) – Registered Nurse, NPI 1063231041

KYLIE SHAFFER (FNP-C) is a healthcare provider. based in Seaside, California. specializing in NURSE PRACTITIONER. They hold the professional credentials FNP-C. They hold a License No. 95204200 (CA). The NPI Number for KYLIE SHAFFER (FNP-C) is 1063231041

Main info

Female
2 Years Of Experience
Accepts Medicare Assignment
Name
KYLIE SHAFFER (FNP-C)
NPI
1063231041
Phone
Not provided
Address
PO BOX 1084
Enumeration Date
7 October 2024
Last Update Date
7 October 2024

Doctor Profile

Medical School Name
GEORGETOWN UNIVERSITY SCHOOL OF MEDICINE
Secondary Phone
8313753577
Graduation Year
2024 (2 years ago)
PAC ID
5890223762
Group Practice PAC ID
1153387386
Professional Enrollment ID
I20250113003358
Address ID
CA939407849MO23XXXDRXX402
Telehealth
Yes
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience26
Completeness75
Years active:1State licenses:1Digital endpointsOther names

16,360 NURSE PRACTITIONER in CA

Provider Addresses for KYLIE SHAFFER (FNP-C)

  • PO BOX 1084

    SEASIDE, CA 939551084

    Phone:

    Type: Mailing

  • 23625 HOLMAN HWY

    MONTEREY, CA 939405902

    Phone: (831) 624-5311

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

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: 2025-01-13

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

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20250113003358INurse PractitionerCATBD

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.

Verify on CMS Revalidation Lookup Tool

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.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 93955)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 1153387386View full group profile
NameSpecialtyState
Nurse PractitionerCA
G A S T R O E N T E R O L O G YNV
G A S T R O E N T E R O L O G YCA
Nurse PractitionerCA
G A S T R O E N T E R O L O G YOR
G A S T R O E N T E R O L O G YCA
G A S T R O E N T E R O L O G YCA
Nurse PractitionerCA
G A S T R O E N T E R O L O G YCA
G A S T R O E N T E R O L O G YCA

Reviews

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Frequently asked questions

What federal number belongs to KYLIE SHAFFER (FNP-C)?
The federal identifier for KYLIE SHAFFER (FNP-C) is NPI 1063231041.
Is KYLIE SHAFFER (FNP-C)'s NPI currently valid?
The extract we use shows KYLIE SHAFFER (FNP-C) as active.
Does KYLIE SHAFFER (FNP-C) list a primary specialty?
If you are matching referrals, note Registered Nurse for KYLIE SHAFFER (FNP-C). Clinical services aligned with this taxonomy classification.
Where does public data place KYLIE SHAFFER (FNP-C)?
The snapshot lists Seaside, California for KYLIE SHAFFER (FNP-C); download NPPES for the complete set.
Is KYLIE SHAFFER (FNP-C) a real provider?
This page reflects official NPPES data for NPI 1063231041. Always confirm identity and privileges with the practice and licensing boards.

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