SHELBY KAITLYN GIBBONS (PA-C) – Surgical Physician Assistant, NPI 1265009781
Surgical Physician Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
1,546 PHYSICIAN ASSISTANT in ID
Provider Addresses for SHELBY KAITLYN GIBBONS (PA-C)
2619 W Fairview Ave
Suite 3100
Boise, ID 83702
Phone:
Type: Location
4011 Talbot Rd S Ste 300
Renton, WA 980555791
Phone: (425) 656-5060
Fax: (425) 656-5047
Type: Location
150 Andover Park W
Tukwila, WA 981882801
Phone: (425) 979-2663
Fax: (425) 524-4447
Type: Location
27005 168th Pl SE Ste 201
Covington, WA 980424902
Phone: (253) 630-3660
Fax: (253) 631-1591
Type: Location
2619 W Fairview Ave Ste 3100
Boise, ID 837026722
Phone: (208) 706-2663
Fax: (208) 486-4300
Type: Location
1620 Lake Tapps Pkwy SE Ste 115
Auburn, WA 980928376
Phone: (253) 246-2860
Fax: (253) 246-2861
Type: Location
5010 99TH AVENUE CT NW
GIG HARBOR, WA 983355953
Phone:
Type: Mailing
190 E BANNOCK ST
BOISE, ID 837126241
Phone:
Fax: (425) 656-5047
Type: Mailing
2619 W FAIRVIEW AVE STE 3100
BOISE, ID 837026722
Phone: (208) 706-2663
Fax: (208) 486-4300
Type: Location
24060 SE Kent Kangley Rd Ste D-100
Maple Valley, WA 980386851
Phone: (425) 358-7708
Fax: (425) 656-5047
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 2 Open Payments records for all available years, with a total value of $62.
Total Amount is formed as General ($62) + Research ($0) + Ownership ($0) = $62.
Last reported payment date: 2024-10-31 • Largest payer in this snapshot: Sawtooth Surgical Solutions Inc ($37).
Total Amount
$62
General + Research + Ownership
Payments
2
Total payment records
General Amount
$62
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-10-31
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Sawtooth Surgical Solutions Inc | $37 |
| Smith+Nephew, Inc. | $25 |
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: 2024-05-13
PECOS data refreshed: 2026-06-15
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 |
|---|---|---|---|---|
| I20221202002909 | I | Physician Assistant | WA | TBD |
| I20240513001585 | I | Physician Assistant | ID | 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 |
|---|---|---|---|---|
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 113 | 87 | $0 |
| 73630 | X-ray of foot, minimum of 3 views | 71 | 52 | $0 |
| 73610 | X-ray of ankle, minimum of 3 views | 55 | 39 | $0 |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 22 | 18 | $0 |
Insurance plans in this area (ZIP 83702)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Physician Assistant | WA | |
| Nurse Practitioner | ID | |
| Physician Assistant | ID | |
| Physician Assistant | ID | |
| - | AZ | |
| Sports Medicine | ID | |
| Physician Assistant | ID | |
| Physician Assistant | CO | |
| Physician Assistant | ID | |
| Physician Assistant | ID |
Reviews
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