DAVID SHANE HAGEMANN (PA) – Physician Assistant, NPI 1881675619
Physician Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
10,570 PHYSICIAN ASSISTANT in CA
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Provider Addresses for DAVID SHANE HAGEMANN (PA)
4301 NORTHSTAR WAY
MODESTO, CA 953569262
Phone: (209) 342-2300
Fax: (209) 524-4240
Type: Mailing
Eden Medical Center, 20103, Lake Chabot Road, Castro Valley, Alameda County, California, 94546, United States
CASTRO VALLEY, CA 945465341
Phone: (209) 342-2300
Fax: (209) 524-4240
Type: Location
1412 BLUE OAKS BLVD
ROSEVILLE, CA 957477143
Phone: (916) 784-7546
Fax: (916) 784-7548
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 279 Open Payments records for all available years, with a total value of $4,984.
Total Amount is formed as General ($4,984) + Research ($0) + Ownership ($0) = $4,984.
Last reported payment date: 2024-12-27 • Largest payer in this snapshot: ABBVIE INC. ($936).
Total Amount
$4,984
General + Research + Ownership
Payments
279
Total payment records
General Amount
$4,984
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-27
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| ABBVIE INC. | $936 |
| GENZYME CORPORATION | $601 |
| Lilly USA, LLC | $522 |
| Sun Pharmaceutical Industries Inc. | $296 |
| LEO Pharma Inc. | $253 |
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: 2015-06-09
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 |
|---|---|---|---|---|
| I20150609002958 | I | Physician Assistant | 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 |
|---|---|---|---|---|
| 17003 | Destruction of precancer skin growth, 2-14 growths | 4,141 | 591 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 1,137 | 622 | $0 |
| 17000 | Destruction of precancer skin growth, 1 growth | 963 | 600 | $0 |
| 11102 | Biopsy of related skin growth, first growth | 724 | 522 | $0 |
| 17110 | Destruction of skin growth, 1-14 growths | 361 | 273 | $0 |
Insurance plans in this area (ZIP 95356)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| PHYSICIAN ASSISTANT | CA | 17003 | Destruction of 2-14 skin growths | 1116 | 243 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| Physician Assistant | CA | |
| D E R M A T O L O G Y | CA | |
| Physician Assistant | CA | |
| D E R M A T O L O G Y | MA | |
| Nurse Practitioner | CA |
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