DR. DAVID B SHANLEY (MD) – Family Medicine Physician, NPI 1154374965
Family Medicine Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
4,141 FAMILY PRACTICE in WA
Provider Addresses for DR. DAVID B SHANLEY (MD)
PO BOX 26666
PHS PROVIDER ENROLLMENT
ALBUQUERQUE, NM 871256666
Phone: (505) 923-6770
Fax: (505) 923-5354
Type: Mailing
6322 Roosevelt Way NE
Seattle, WA 981156625
Phone: (206) 201-0544
Type: Location
6322, Roosevelt Way Northeast, Green Lake, Seattle, King County, Washington, 98115, United States
SEATTLE, WA 981156625
Phone: (206) 201-0544
Type: Location
620 NW 11TH ST STE M201
HERMISTON, OR 978386941
Phone: (541) 289-4118
Fax: (541) 667-3484
Type: Mailing
620 NW 11TH ST STE M103
HERMISTON, OR 978386941
Phone: (541) 667-3830
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.
This can happen when there are no reportable CMS Open Payments records.
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: 2011-08-18
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 |
|---|---|---|---|---|
| I20110818000855 | I | Family Practice | NM | 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.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 87125)
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Group practice members
- 1
- 2
- 3
- 4
| Name | Specialty | State |
|---|---|---|
| U R O L O G Y | LA | |
| - | NM | |
| - | NM | |
| Physician Assistant | NM | |
| Physician Assistant | NM | |
| - | NM | |
| Family Practice | NM | |
| Internal Medicine | AZ | |
| Geriatric Medicine | HI | |
| Nurse Practitioner | NM |
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