SHADRACH J JR. SMITH (M.D.) – Internal Medicine Physician, NPI 1093770299
Internal Medicine Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
1,293 INTERNAL MEDICINE in KS
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Provider Addresses for SHADRACH J JR. SMITH (M.D.)
12140, Nall Avenue, Overland Park, Johnson County, Kansas, 66209, United States
SUITE 100
OVERLAND PARK, KS 66209
Phone: (913) 451-8500
Fax: (913) 451-1754
Mailing address matches the actual address.
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 231 Open Payments records for all available years, with a total value of $4,775.
Total Amount is formed as General ($4,775) + Research ($0) + Ownership ($0) = $4,775.
Last reported payment date: 2024-12-26 • Largest payer in this snapshot: Novo Nordisk Inc ($1,140).
Total Amount
$4,775
General + Research + Ownership
Payments
231
Total payment records
General Amount
$4,775
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-26
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Novo Nordisk Inc | $1,140 |
| Lilly USA, LLC | $592 |
| Abbott Laboratories | $239 |
| Boehringer Ingelheim Pharmaceuticals, Inc. | $235 |
| AstraZeneca Pharmaceuticals LP | $223 |
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: 2010-08-30
PECOS data refreshed: 2026-06-15
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 |
|---|---|---|---|---|
| I20100830000906 | I | Internal Medicine | MO | 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 |
|---|---|---|---|---|
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 115 | 48 | $0 |
| 96372 | Injection of drug or substance under skin or into muscle | 73 | 32 | $0 |
| J3420 | Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg | 73 | 32 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 38 | 24 | $0 |
| 36415 | Insertion of needle into vein for collection of blood sample | 16 | 15 | $0 |
Insurance plans in this area (ZIP 66209)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Family Practice | KS | |
| - | KS | |
| - | MO | |
| - | KS | |
| - | KS | |
| - | MO | |
| - | KS | |
| Cardiovascular Disease (Cardiology), Internal Medicine | KS | |
| Family Practice | KS | |
| Family Practice | MO |
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