AMANDA SHAW (PMHNP) – Psychiatric/Mental Health Nurse Practitioner, NPI 1083362560

AMANDA SHAW (PMHNP) is a healthcare provider. based in Huntington beach, California. specializing in NURSE PRACTITIONER. They hold the professional credentials PMHNP. They hold a License No. 95019414 (CA). The NPI Number for AMANDA SHAW (PMHNP) is 1083362560

Main info

Female
Sole Proprietor
5 Years Of Experience
Accepts Medicare Assignment
Name
AMANDA SHAW (PMHNP)
NPI
1083362560
Phone
(661) 319-7834
Address
18602 DEMION LN APT C
Enumeration Date
14 March 2022
Last Update Date
14 March 2022

Doctor Profile

Medical School Name
OTHER
Secondary Phone
8887954337
Graduation Year
2021 (5 years ago)
PAC ID
0749622298
Group Practice PAC ID
9335475870
Professional Enrollment ID
I20240529002321
Address ID
CA926537906LA23201DRXX401
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience32
Completeness75
Years active:4State licenses:1Digital endpointsOther names

16,538 NURSE PRACTITIONER in CA

Provider Addresses for AMANDA SHAW (PMHNP)

  • 18602 DEMION LN APT C

    HUNTINGTON BEACH, CA 926468812

    Phone: (661) 319-7834

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 1 Open Payments records for all available years, with a total value of $22.

Total Amount is formed as General ($22) + Research ($0) + Ownership ($0) = $22.

Last reported payment date: 2024-05-17 • Largest payer in this snapshot: ATRICURE, INC. ($22).

Total Amount

$22

General + Research + Ownership

Payments

1

Total payment records

General Amount

$22

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-05-17

Latest reported date

Top Companies

Largest payers in this snapshot

CompanyAmount
ATRICURE, INC.$22
View all Open Payments →|Open Payments Risk Radar →

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: 2024-05-29

PECOS data refreshed: 2026-06-15

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
I20240529002321INurse 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 92646)

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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: 9335475870View full group profile
NameSpecialtyState
Marriage And Family TherapistCA
Clinical Social WorkerCA
Marriage And Family TherapistCA
Marriage And Family TherapistCA
Clinical Social WorkerWA
Marriage And Family TherapistCA
Marriage And Family TherapistCA
Marriage And Family TherapistCA
Marriage And Family TherapistCA
Clinical Social WorkerCA

Reviews

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Frequently asked questions

What federal number belongs to AMANDA SHAW (PMHNP)?
The federal identifier for AMANDA SHAW (PMHNP) is NPI 1083362560.
Does this profile mean AMANDA SHAW (PMHNP) is currently active?
Yes — AMANDA SHAW (PMHNP) appears active in the national provider directory.
What kind of provider is AMANDA SHAW (PMHNP)?
The page reflects Psychiatric/Mental Health Nurse Practitioner for AMANDA SHAW (PMHNP). Clinical services aligned with this taxonomy classification.
Where is AMANDA SHAW (PMHNP)'s primary listing?
We display Huntington Beach, California because that is what the record indicates for AMANDA SHAW (PMHNP).
Is this NPI for an individual or an organization?
This listing corresponds to an Individual Provider.

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