MR. SHELBY TANNER MOLLENKAMP (CRNA) – Certified Registered Nurse Anesthetist, NPI 1578021374
Certified Registered Nurse Anesthetist
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
966 CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA) in KS
Provider Addresses for MR. SHELBY TANNER MOLLENKAMP (CRNA)
4, East Piankishaw Street, Paola, Miami County, Kansas, 66071, United States
PAOLA, KS 660711717
Phone: (785) 754-8265
Type: Mailing
200 S 5th St Ste A
Salina, KS 674013906
Phone: (785) 827-2238
Fax: (785) 827-1684
Type: Location
Stormont Vail Health, 1500, Southwest 10th Avenue, Topeka, Shawnee County, Kansas, 66604, United States
TOPEKA, KS 666041301
Phone: (785) 354-6000
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 1 Open Payments records for all available years, with a total value of $17.
Total Amount is formed as General ($17) + Research ($0) + Ownership ($0) = $17.
Last reported payment date: 2024-08-13 • Largest payer in this snapshot: Edwards Lifesciences Corporation ($17).
Total Amount
$17
General + Research + Ownership
Payments
1
Total payment records
General Amount
$17
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-08-13
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Edwards Lifesciences Corporation | $17 |
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: 2024-06-25
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 2 Medicare enrollment records; no due dates published yet.
Enrollment records
2
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 |
|---|---|---|---|---|
| I20190618002472 | I | Certified Registered Nurse Anesthetist (Crna) | KS | TBD |
| I20240625003815 | I | Certified Registered Nurse Anesthetist (Crna) | NC | 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 66071)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Certified Registered Nurse Anesthetist (Crna) | NE | |
| Certified Registered Nurse Anesthetist (Crna) | NE | |
| Certified Registered Nurse Anesthetist (Crna) | FL | |
| Certified Registered Nurse Anesthetist (Crna) | KS | |
| Certified Registered Nurse Anesthetist (Crna) | MO | |
| Certified Registered Nurse Anesthetist (Crna) | AK | |
| Certified Registered Nurse Anesthetist (Crna) | KS | |
| Certified Registered Nurse Anesthetist (Crna) | KS | |
| Certified Registered Nurse Anesthetist (Crna) | MO | |
| General Surgery | KS |
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