KATHRYN THERESE SHAHWAN (MD) – MOHS-Micrographic Surgery Physician, NPI 1699193714
MOHS-Micrographic Surgery Physician
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NPPES metrics only — not quality of care.
419 DERMATOLOGY in MN
Provider Addresses for KATHRYN THERESE SHAHWAN (MD)
3850 PARK NICOLLET BLVD
ST LOUIS PARK, MN 554162527
Phone: (952) 993-3400
Type: Mailing
2050 KENNY RD
COLUMBUS, OH 432213502
Phone: (614) 293-0404
Fax: (614) 366-7147
Type: Location
700 ACKERMAN RD STE 2120
COLUMBUS, OH 432021559
Phone: (614) 293-0404
Fax: (614) 366-7147
Type: Mailing
2050 KENNY RD FL 4
COLUMBUS, OH 432213502
Phone: (614) 293-0404
Fax: (614) 366-7147
Type: Location
2401 DEMERS AVE
GRAND FORKS, ND 582014183
Phone: (701) 780-1891
Type: Mailing
3165 DEMERS AVE
GRAND FORKS, ND 58201
Phone: (701) 780-6000
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.
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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: 2022-01-14
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 |
|---|---|---|---|---|
| I20220114001102 | I | Dermatology | OH | 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 |
|---|---|---|---|---|
| 17311 | Removal and microscopic exam of growth of head, neck, hands, feet, or genitals, 1-5 tissue blocks | 389 | 329 | $0 |
| 17312 | Removal and microscopic exam of growth of head, neck, hands, feet, or genitals, each additional stage, 1-5 tissue blocks | 174 | 129 | $0 |
| 12052 | Intermediate repair of wound of face, ears, eyelids, nose, lips, or mouth, 2.6-5.0 cm | 106 | 103 | $0 |
| 11102 | Biopsy of related skin growth, first growth | 69 | 59 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 43 | 38 | $0 |
Insurance plans in this area (ZIP 55416)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Cardiovascular Disease (Cardiology), Internal Medicine | PA | |
| - | OH | |
| Nurse Practitioner | OH | |
| Hospitalist, Internal Medicine | OH | |
| Nurse Practitioner | OH | |
| Medical Oncology | OH | |
| Medical Oncology | OH | |
| H E M A T O L O G Y/ O N C O L O G Y | CA | |
| Nurse Practitioner | OH | |
| H O S P I T A L I S T | OH |
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