DR. SHELLY BANSAL (MD) – Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician, NPI 1174793111
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
241 THORACIC SURGERY in OH
Provider Addresses for DR. SHELLY BANSAL (MD)
3533 Southern Blvd Ste 5650
Kettering, OH 454291263
Phone: (937) 294-3611
Fax: (937) 294-9010
Type: Location
875 POPLAR CHURCH RD
CAMP HILL, PA 170112203
Phone: (717) 975-0900
Type: Location
802 N RIVERSIDE RD STE 210
SAINT JOSEPH, MO 645072509
Phone: (816) 271-6200
Fax: (816) 271-6749
Type: Location
201, North Silverbell Road, Menlo Park, Tucson, Pima County, Arizona, 85745, United States
TUCSON, AZ 857452686
Phone: (520) 396-1370
Fax: (520) 396-1375
Type: Mailing
3533 SOUTHERN BLVD STE 5650
KETTERING, OH 454291263
Phone: (937) 294-3611
Fax: (937) 294-9010
Type: Location
5301 E Grant Rd
Tucson, AZ 857122805
Phone: (520) 324-5461
Fax: (520) 324-1406
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 22 Open Payments records for all available years, with a total value of $3,418.
Total Amount is formed as General ($3,418) + Research ($0) + Ownership ($0) = $3,418.
Last reported payment date: 2024-11-21 • Largest payer in this snapshot: ATRICURE, INC. ($1,288).
Total Amount
$3,418
General + Research + Ownership
Payments
22
Total payment records
General Amount
$3,418
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-11-21
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| ATRICURE, INC. | $1,288 |
| Intuitive Surgical, Inc. | $1,063 |
| ABIOMED | $828 |
| Abbott Laboratories | $151 |
| Titan Surgical Group, Llc | $39 |
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: 2025-04-30
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 4 Medicare enrollment records; no due dates published yet.
Enrollment records
4
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 |
|---|---|---|---|---|
| I20200526001717 | I | Thoracic Surgery | AZ | TBD |
| I20210312001096 | I | Thoracic Surgery | MI | TBD |
| I20211022001402 | I | General Surgery | WV | TBD |
| I20250430000091 | I | Thoracic Surgery | CA | 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 45429)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| - | CA | |
| H E M A T O L O G Y/ O N C O L O G Y | CA | |
| Diagnostic Radiology | CA | |
| Thoracic Surgery, General Surgery | TX | |
| - | CA | |
| - | CA | |
| Vascular Surgery | CA | |
| - | CA | |
| - | CA | |
| Family Practice | CA |
Reviews
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