MR. SHAWN C VREDENBURG (PA) – Physician Assistant, NPI 1194079277

MR. SHAWN C VREDENBURG (PA) is a healthcare provider. based in Wichita, Kansas. specializing in PHYSICIAN ASSISTANT. They hold the professional credentials PA. They hold a License No. T03473 (KS). The NPI Number for MR. SHAWN C VREDENBURG (PA) is 1194079277

Main info

Male
14 Years Of Experience
Accepts Medicare Assignment
Name
MR. SHAWN C VREDENBURG (PA)
NPI
1194079277
Phone
(316) 617-8546
Address
1121 S DODGE AVE
Enumeration Date
29 October 2012
Last Update Date
18 July 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
7854752208
Graduation Year
2012 (14 years ago)
PAC ID
7517112568
Group Practice PAC ID
8022928225
Professional Enrollment ID
I20220824002090
Address ID
KS677492450OB810XXSTXX402
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience50
Completeness85
Years active:13State licenses:1Digital endpointsOther names

1,303 PHYSICIAN ASSISTANT in KS

Provider Addresses for MR. SHAWN C VREDENBURG (PA)

  • 1121 S DODGE AVE

    WICHITA, KS 672134436

    Phone: (316) 617-8546

    Type: Mailing

  • 3311 E MURDOCK ST

    WICHITA, KS 672083054

    Phone: (316) 689-9107

    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: 2013-02-25

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

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20130225000213IPhysician AssistantKSTBD

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.

Verify on CMS Revalidation Lookup Tool

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

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99285Emergency department visit with high level of medical decision making8480$0
99284Emergency department visit with moderate level of medical decision making7064$0
99283Emergency department visit with low level of medical decision making4949$0
99291Critical care, first 30-74 minutes1414$0
View full utilization report →

Insurance plans in this area (ZIP 67213)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 8022928225View full group profile
NameSpecialtyState
Physician AssistantKS
Family PracticeKS
Family PracticeNE

Reviews

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Frequently asked questions

Can I use this page to confirm MR. SHAWN C VREDENBURG (PA)'s NPI?
Yes. MR. SHAWN C VREDENBURG (PA) is listed with NPI 1194079277 in the public NPI dataset.
Is MR. SHAWN C VREDENBURG (PA) listed as active for patients and plans?
The listing shows MR. SHAWN C VREDENBURG (PA) as active in the NPI system.
What is MR. SHAWN C VREDENBURG (PA)'s primary classification?
Physician Assistant is the headline specialty for MR. SHAWN C VREDENBURG (PA) here. Clinical services aligned with this taxonomy classification.
What area does MR. SHAWN C VREDENBURG (PA) serve?
MR. SHAWN C VREDENBURG (PA)'s listing highlights Wichita, Kansas; more addresses can appear in NPPES.
Is the information about MR. SHAWN C VREDENBURG (PA) up to date?
Data updates when providers file changes in NPPES — treat critical facts as "verify if unsure."

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