KYLEE SHAW (PA) – Medical Physician Assistant, NPI 1225518509
Medical Physician Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
1,223 PHYSICIAN ASSISTANT in NV
Provider Addresses for KYLEE SHAW (PA)
895 Adams Blvd
Boulder City, NV 890052235
Phone: (702) 293-0406
Fax: (702) 293-0192
Type: Location
1411 FALLS AVE E STE 1002
TWIN FALLS, ID 833013459
Phone: (208) 595-5424
Type: Location
895, Adams Boulevard, Boulder City, Clark County, Nevada, 89005, United States
BOULDER CITY, NV 890052235
Phone: (702) 293-0406
Fax: (702) 293-0192
Type: Mailing
147 W CHUBBUCK RD
CHUBBUCK, ID 832022314
Phone: (208) 238-7546
Fax: (208) 237-9643
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 7 Open Payments records for all available years, with a total value of $135.
Total Amount is formed as General ($135) + Research ($0) + Ownership ($0) = $135.
Last reported payment date: 2024-04-22 • Largest payer in this snapshot: ABBVIE INC. ($82).
Total Amount
$135
General + Research + Ownership
Payments
7
Total payment records
General Amount
$135
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-04-22
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| ABBVIE INC. | $82 |
| Sun Pharmaceutical Industries Inc. | $34 |
| Dermavant Sciences, Inc. | $19 |
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: 2023-09-20
PECOS data refreshed: 2026-06-15
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 |
|---|---|---|---|---|
| I20230920003563 | I | Physician Assistant | ID | 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 |
|---|---|---|---|---|
| 17003 | Destruction of precancer skin growth, 2-14 growths | 82 | 21 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 36 | 35 | $0 |
| 17000 | Destruction of precancer skin growth, 1 growth | 31 | 30 | $0 |
| 11102 | Biopsy of related skin growth, first growth | 14 | 14 | $0 |
| 17110 | Destruction of skin growth, 1-14 growths | 13 | 13 | $0 |
Insurance plans in this area (ZIP 89005)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Physician Assistant | ID | |
| Micrographic Dermatologic Surgery (Mds), Dermatology | ID | |
| D E R M A T O L O G Y | WA | |
| Physician Assistant | ID | |
| Micrographic Dermatologic Surgery (Mds) | ID | |
| Physician Assistant | ID |
Reviews
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