KRISTA E. SHACKELFORD (M.D.) – Dermatology Physician, NPI 1922038801
Dermatology Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
99 DERMATOLOGY in KS
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Provider Addresses for KRISTA E. SHACKELFORD (M.D.)
North Hillside Street, Wichita, Sedgwick County, Kansas, 67219, United States
WICHITA, KS 672144913
Phone: (316) 685-4395
Fax: (316) 685-1149
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 38 Open Payments records for all available years, with a total value of $1,012.
Total Amount is formed as General ($1,012) + Research ($0) + Ownership ($0) = $1,012.
Last reported payment date: 2024-12-12 • Largest payer in this snapshot: E.R. Squibb & Sons, L.L.C. ($397).
Total Amount
$1,012
General + Research + Ownership
Payments
38
Total payment records
General Amount
$1,012
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-12
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| E.R. Squibb & Sons, L.L.C. | $397 |
| ABBVIE INC. | $323 |
| Novartis Pharmaceuticals Corporation | $113 |
| Dermavant Sciences, Inc. | $50 |
| GENZYME CORPORATION | $48 |
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: 2007-10-08
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 |
|---|---|---|---|---|
| I20071008000172 | I | Dermatology | KS | 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 |
|---|---|---|---|---|
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 927 | 774 | $0 |
| 17003 | Destruction of precancer skin growth, 2-14 growths | 562 | 120 | $0 |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 263 | 234 | $0 |
| 17000 | Destruction of precancer skin growth, 1 growth | 240 | 210 | $0 |
| 17110 | Destruction of skin growth, 1-14 growths | 133 | 125 | $0 |
Insurance plans in this area (ZIP 67214)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| DERMATOLOGY | KS | 17003 | Destruction of 2-14 skin growths | 1143 | 206 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| - | KS | |
| Physician Assistant | SC | |
| Physician Assistant | KS | |
| Dermatology, Pathology | KS | |
| D E R M A T O L O G Y | OH | |
| Physician Assistant | KS | |
| D E R M A T O L O G Y | KS |
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