DR. SHIRLEY LYNNE VAN (MD) – Dermatology Physician, NPI 1063530749
Dermatology Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
2,140 DERMATOLOGY in CA
Provider Addresses for DR. SHIRLEY LYNNE VAN (MD)
1429 COLLEGE AVE
SUITE B
MODESTO, CA 953504057
Phone: (209) 526-2242
Type: Mailing
862 AEROVISTA PL STE 100
SAN LUIS OBISPO, CA 934018758
Phone: (805) 549-8023
Fax: (805) 549-8252
Type: Location
26800 Crown Valley Pkwy Ste 435
Mission Viejo, CA 926918023
Phone: (949) 573-9510
Type: Location
5767 W CENTURY BLVD STE 400
LOS ANGELES, CA 900455631
Phone:
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 13 Open Payments records for all available years, with a total value of $536.
Total Amount is formed as General ($536) + Research ($0) + Ownership ($0) = $536.
Last reported payment date: 2024-03-11 • Largest payer in this snapshot: ABBVIE INC. ($215).
Total Amount
$536
General + Research + Ownership
Payments
13
Total payment records
General Amount
$536
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-03-11
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| ABBVIE INC. | $215 |
| Amgen Inc. | $128 |
| Lilly USA, LLC | $93 |
| GENZYME CORPORATION | $30 |
| E.R. Squibb & Sons, L.L.C. | $26 |
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: 2024-04-11
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 2 Medicare enrollment records; no due dates published yet.
Enrollment records
2
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 |
|---|---|---|---|---|
| I20080314000495 | I | Dermatology | CA | TBD |
| I20240411002067 | I | Dermatology | IL | 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 |
|---|---|---|---|---|
| 17003 | Destruction of precancer skin growth, 2-14 growths | 316 | 57 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 89 | 81 | $0 |
| 17000 | Destruction of precancer skin growth, 1 growth | 73 | 66 | $0 |
| 99212 | Established patient office or other outpatient visit, 10-19 minutes | 60 | 52 | $0 |
| 17110 | Destruction of skin growth, 1-14 growths | 45 | 38 | $0 |
Insurance plans in this area (ZIP 95350)
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