SHANE K WALLACE (CRNA) – Certified Registered Nurse Anesthetist, NPI 1235378605
Certified Registered Nurse Anesthetist
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Profile Insights
NPPES metrics only — not quality of care.
1,371 CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA) in KY
Provider Addresses for SHANE K WALLACE (CRNA)
911 BYPASS RD BLDG A
PIKEVILLE, KY 415011689
Phone: (606) 430-3500
Fax: (606) 437-1033
Type: Location
Pikeville Post Office, Big Daddy's Road, Pikeville, Wayne County, North Carolina, 27863, United States
PIKEVILLE, KY 415022917
Phone: (606) 218-3500
Type: Mailing
South Bypass Road, Pikeville, Pike County, Kentucky, 41501, United States
PIKEVILLE, KY 415011689
Phone: (606) 218-3500
Type: Location
PO BOX 432
PIKEVILLE, KY 415020432
Phone: (606) 430-3500
Fax: (606) 437-1033
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 10 Open Payments records for all available years, with a total value of $217.
Total Amount is formed as General ($217) + Research ($0) + Ownership ($0) = $217.
Last reported payment date: 2024-11-13 • Largest payer in this snapshot: Merck Sharp & Dohme LLC ($88).
Total Amount
$217
General + Research + Ownership
Payments
10
Total payment records
General Amount
$217
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-11-13
Latest reported date
Top Companies
Largest payers in this snapshot
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: 2023-08-01
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 3 Medicare enrollment records; no due dates published yet.
Enrollment records
3
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 |
|---|---|---|---|---|
| I20090429000349 | I | Certified Registered Nurse Anesthetist (Crna) | VA | TBD |
| I20131010001011 | I | Certified Registered Nurse Anesthetist (Crna) | KY | TBD |
| I20230801000310 | I | Certified Registered Nurse Anesthetist (Crna) | TN | 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 |
|---|---|---|---|---|
| 00731 | Anesthesia for other procedure on esophagus, stomach, or upper small bowel using an endoscope | 18 | 18 | $0 |
| 00813 | Anesthesia for procedure on small and large bowel using an endoscope | 14 | 14 | $0 |
| 00811 | Anesthesia for other procedure on large bowel using an endoscope | 13 | 13 | $0 |
Insurance plans in this area (ZIP 41501)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| CERTIFIED REGISTERED NURSE ANESTHET | KY | 01402 | Anesthesia for open or endoscopic total knee joint replacement | 18 | 18 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| - | KY | |
| Nurse Practitioner | KY | |
| Nurse Practitioner | KY | |
| - | KY | |
| Hematology/Oncology, Internal Medicine | KY | |
| - | KY | |
| Physician Assistant | KY | |
| Critical Care (Intensivists) | OH | |
| Emergency Medicine | OH | |
| Certified Registered Nurse Anesthetist (Crna) | KY |
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