KENNETH F SHOCKLEY (D.O.) – Urology Physician, NPI 1801854039
Urology Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
469 UROLOGY in MI
Provider Addresses for KENNETH F SHOCKLEY (D.O.)
4047 SALADIN DR SE
GRAND RAPIDS, MI 495466249
Phone: (616) 956-9577
Fax: (616) 956-5988
Type: Location
20952 E 12 MILE RD STE 200
SAINT CLAIR SHORES, MI 480813203
Phone: (586) 771-4820
Type: Mailing
4047 E HILLS CT SE
GRAND RAPIDS, MI 495466249
Phone: (616) 956-9577
Fax: (616) 956-5988
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 53 Open Payments records for all available years, with a total value of $2,270.
Total Amount is formed as General ($2,270) + Research ($0) + Ownership ($0) = $2,270.
Last reported payment date: 2024-12-20 • Largest payer in this snapshot: Boston Scientific Corporation ($594).
Total Amount
$2,270
General + Research + Ownership
Payments
53
Total payment records
General Amount
$2,270
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-20
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Boston Scientific Corporation | $594 |
| Astellas Pharma US Inc | $392 |
| Axonics, Inc. | $205 |
| PROCEPT BioRobotics Corporation | $137 |
| Teleflex LLC | $133 |
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: 2008-04-04
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 |
|---|---|---|---|---|
| I20080404000199 | I | Urology | MI | 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 |
|---|---|---|---|---|
| 81000 | Manual urinalysis test with examination using microscope, non-automated | 175 | 133 | $0 |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 118 | 99 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 92 | 80 | $0 |
| 52000 | Diagnostic exam of bladder and urethra using an endoscope | 53 | 43 | $0 |
| 51798 | Ultrasound measurement of bladder capacity after voiding | 16 | 15 | $0 |
Insurance plans in this area (ZIP 49546)
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Provider's Procedures
Group practice members
| Name | Specialty | State |
|---|---|---|
| Internal Medicine | MI | |
| - | MI | |
| Nurse Practitioner | MI | |
| Physician Assistant | MI | |
| Hospitalist, Internal Medicine | MI | |
| - | MI | |
| Family Practice | MI | |
| Physician Assistant | MI | |
| - | MI | |
| Physician Assistant | MI |
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