SHANNON BOCK (PA-C) – Physician Assistant, NPI 1083662225
Physician Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
4,161 PHYSICIAN ASSISTANT in CO
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Provider Addresses for SHANNON BOCK (PA-C)
12596, West Bayaud Avenue, Lakewood, Jefferson County, Colorado, 80228, United States
STE 205
LAKEWOOD, CO 802282018
Phone: (720) 713-1885
Type: Mailing
Summit Boulevard, Rockvue, City and County of Broomfield, Colorado, 80021, United States
STE 201
BROOMFIELD, CO 80021
Phone: (303) 429-6448
Fax: (303) 951-3701
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 15 Open Payments records for all available years, with a total value of $469.
Total Amount is formed as General ($469) + Research ($0) + Ownership ($0) = $469.
Last reported payment date: 2024-07-17 • Largest payer in this snapshot: Boston Scientific Corporation ($288).
Total Amount
$469
General + Research + Ownership
Payments
15
Total payment records
General Amount
$469
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-07-17
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Boston Scientific Corporation | $288 |
| SPR Therapeutics, Inc | $129 |
| PAINTEQ LLC | $28 |
| Nevro Corp. | $23 |
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: 2005-03-12
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 |
|---|---|---|---|---|
| I20050312000092 | I | Physician Assistant | CO | 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.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 80228)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| A N E S T H E S I O L O G Y | CO |
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