MRS. SHANNON L GARDINER (PA) – Surgical Physician Assistant, NPI 1689701260
Surgical Physician Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
1,531 PHYSICIAN ASSISTANT in ID
Provider Addresses for MRS. SHANNON L GARDINER (PA)
360 E MONTVUE DR
SUITE 100
MERIDIAN, ID 836426318
Phone: (208) 855-2900
Fax: (208) 898-9877
Type: Mailing
360 E Montvue Dr
Suite 100
Meridian, ID 836426318
Phone: (208) 855-2900
Fax: (208) 898-9877
Type: Location
875 S VANGUARD WAY STE 200
MERIDIAN, ID 836428542
Phone: (208) 809-2895
Fax: (208) 809-2896
Type: Location
PO BOX 191050
BOISE, ID 837191050
Phone: (208) 985-1423
Fax: (208) 955-6501
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 6 Open Payments records for all available years, with a total value of $295.
Total Amount is formed as General ($295) + Research ($0) + Ownership ($0) = $295.
Last reported payment date: 2024-11-12 • Largest payer in this snapshot: Regeneron Healthcare Solutions, Inc. ($125).
Total Amount
$295
General + Research + Ownership
Payments
6
Total payment records
General Amount
$295
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-11-12
Latest reported date
Top Companies
Largest payers in this snapshot
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: 2005-01-13
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 |
|---|---|---|---|---|
| I20050113000517 | 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 |
|---|---|---|---|---|
| 69210 | Removal of impacted ear wax | 194 | 98 | $0 |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 181 | 119 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 143 | 105 | $0 |
| 31575 | Diagnostic exam of voice box using a flexible endoscope | 64 | 55 | $0 |
| 99204 | New patient office or other outpatient visit, 45-59 minutes | 54 | 54 | $0 |
Insurance plans in this area (ZIP 83642)
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Group practice members
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