JOHN EDWIN SHUMAN (PA) – Surgical Physician Assistant, NPI 1104808625

JOHN EDWIN SHUMAN (PA) is a healthcare provider. based in Saint louis, Missouri. specializing in PHYSICIAN ASSISTANT. They hold the professional credentials PA. They hold a License No. 2003026623 (MO). The NPI Number for JOHN EDWIN SHUMAN (PA) is 1104808625

Main info

Male
29 Years Of Experience
Accepts Medicare Assignment
Name
JOHN EDWIN SHUMAN (PA)
NPI
1104808625
Phone
(314) 251-5570
Address
621 S NEW BALLAS RD
Enumeration Date
18 November 2005
Last Update Date
7 December 2016

Doctor Profile

Medical School Name
OTHER
Secondary Phone
3142518750
Graduation Year
1997 (29 years ago)
PAC ID
4688560808
Group Practice PAC ID
4688622822
Professional Enrollment ID
I20060124000042
Address ID
MO631418725SA701XXRDXX517
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience54
Completeness75
Years active:20State licenses:1Digital endpointsOther names

1,853 PHYSICIAN ASSISTANT in MO

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Provider Addresses for JOHN EDWIN SHUMAN (PA)

  • 621, South New Ballas Road, Creve Coeur, Saint Louis County, Missouri, 63141, United States

    SUITE 7003B

    SAINT LOUIS, MO 631418232

    Phone: (314) 251-5570

    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 23 Open Payments records for all available years, with a total value of $1,281.

Total Amount is formed as General ($1,281) + Research ($0) + Ownership ($0) = $1,281.

Last reported payment date: 2024-12-10 • Largest payer in this snapshot: Avita Medical Americas, Llc ($232).

Total Amount

$1,281

General + Research + Ownership

Payments

23

Total payment records

General Amount

$1,281

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-12-10

Latest reported date

View all Open Payments →|Open Payments Risk Radar →

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: 2006-01-24

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

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20060124000042IPhysician AssistantMOTBD

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.

Verify on CMS Revalidation Lookup Tool

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 63141)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 4688622822View full group profile
NameSpecialtyState
Plastic And Reconstructive SurgeryMO
Physician AssistantMO
Plastic And Reconstructive Surgery, General SurgeryMO
-MO
Nurse PractitionerMO
Plastic And Reconstructive SurgeryMI
Plastic And Reconstructive SurgeryMO
-MO
Nurse PractitionerMO
-MO

Reviews

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Frequently asked questions

What is the 10-digit NPI for JOHN EDWIN SHUMAN (PA)?
JOHN EDWIN SHUMAN (PA) — NPI 1104808625 — is the standard way to identify this listing.
Does CMS list JOHN EDWIN SHUMAN (PA) as active?
Yes — JOHN EDWIN SHUMAN (PA) is active in the NPI listing used on this page.
What is JOHN EDWIN SHUMAN (PA)'s specialty?
The listing groups JOHN EDWIN SHUMAN (PA) with Surgical Physician Assistant. Clinical services aligned with this taxonomy classification.
Where should I expect JOHN EDWIN SHUMAN (PA) on a map?
Expect Saint Louis, Missouri as a primary anchor for JOHN EDWIN SHUMAN (PA) unless the record lists multiple sites.
What does 'Individual Provider' mean on this profile?
Entity type tells you whether the number belongs to a person or an organization.

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