MS. SHANTALL VIRIDIANA HALL (D.O.) – Emergency Medicine Physician, NPI 1174759807
Emergency Medicine Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
1,179 EMERGENCY MEDICINE in AZ
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Provider Addresses for MS. SHANTALL VIRIDIANA HALL (D.O.)
2000, Spring Road, Oak Brook, DuPage County, Illinois, 60523, United States
SUITE 200
OAK BROOK, IL 605231804
Phone: (630) 472-8800
Fax: (630) 472-9502
Type: Mailing
Banner Thunderbird Medical Center, 5555, West Thunderbird Road, Glendale, Maricopa County, Arizona, 85306, United States
GLENDALE, AZ 853064622
Phone: (602) 588-5555
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
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: 2009-09-16
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 |
|---|---|---|---|---|
| I20090916000168 | I | Emergency Medicine | AZ | 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 60523)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Emergency Medicine | AZ | |
| Emergency Medicine | AZ | |
| Emergency Medicine | TX | |
| Family Practice | AZ | |
| Family Practice, Emergency Medicine | GA | |
| Emergency Medicine | AZ | |
| Emergency Medicine | CA | |
| Emergency Medicine | AZ | |
| Family Practice, Emergency Medicine | AZ | |
| Emergency Medicine | CA |
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