SHAUN MICHAEL RUDICIL – Physician Assistant, NPI 1770782062
Physician Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
5,035 PHYSICIAN ASSISTANT in IL
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Provider Addresses for SHAUN MICHAEL RUDICIL
Fort Jesse Road, Normal, McLean County, Illinois, 61761, United States
SUITE 250
NORMAL, IL 617616286
Phone: (309) 454-1616
Fax: (309) 454-5167
Type: Mailing
501A S Towanda Barnes Rd Ste 2
Bloomington, IL 617054031
Phone: (309) 612-9002
Fax: (309) 391-0134
Type: Location
1120 N MELVIN ST
GIBSON CITY, IL 609361477
Phone: (217) 784-4251
Type: Mailing
3101 FIELDS SOUTH DR
CHAMPAIGN, IL 618223743
Phone: (217) 366-1237
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 9 Open Payments records for all available years, with a total value of $142.
Total Amount is formed as General ($142) + Research ($0) + Ownership ($0) = $142.
Last reported payment date: 2024-08-30 • Largest payer in this snapshot: Ferring Pharmaceuticals Inc. ($105).
Total Amount
$142
General + Research + Ownership
Payments
9
Total payment records
General Amount
$142
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-08-30
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Ferring Pharmaceuticals Inc. | $105 |
| Bioventus LLC | $37 |
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: 2007-08-22
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 |
|---|---|---|---|---|
| I20070822001031 | I | Physician Assistant | IL | 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 |
|---|---|---|---|---|
| J0702 | Injection, betamethasone acetate 3 mg and betamethasone sodium phosphate 3 mg | 232 | 55 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 207 | 143 | $0 |
| 20610 | Aspiration and/or injection of fluid from large joint | 132 | 81 | $0 |
| 99203 | New patient office or other outpatient visit, 30-44 minutes | 84 | 84 | $0 |
| 73502 | X-ray of hip, 2-3 views | 44 | 33 | $0 |
Insurance plans in this area (ZIP 61761)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| PHYSICIAN ASSISTANT | IL | 20610 | Aspiration and/or injection of large joint or joint capsule | 56 | 29 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| Physical Therapist In Private Practice | IL | |
| - | IL | |
| Diagnostic Radiology | IN | |
| - | IL | |
| Nurse Practitioner | IL | |
| Nurse Practitioner | IL | |
| - | IL | |
| Emergency Medicine | MN | |
| - | IL | |
| - | IL |
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