SHAWN FADUM (PA) – Medical Physician Assistant, NPI 1013374271
Medical Physician Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
1,797 PHYSICIAN ASSISTANT in OK
Provider Addresses for SHAWN FADUM (PA)
1104 WALNUT DR
ARDMORE, OK 734012353
Phone: (580) 226-0543
Fax: (580) 226-2284
Type: Mailing
1306 12th Ave NW
Ardmore, OK 734011285
Phone: (580) 223-6004
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 1 Open Payments records for all available years, with a total value of $17.
Total Amount is formed as General ($17) + Research ($0) + Ownership ($0) = $17.
Last reported payment date: 2024-01-24 • Largest payer in this snapshot: Hologic Sales and Service, LLC ($17).
Total Amount
$17
General + Research + Ownership
Payments
1
Total payment records
General Amount
$17
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-01-24
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Hologic Sales and Service, LLC | $17 |
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: 2017-08-15
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 |
|---|---|---|---|---|
| I20170815001722 | I | Physician Assistant | OK | 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 |
|---|---|---|---|---|
| J1100 | Injection, dexamethasone sodium phosphate, 1 mg | 300 | 32 | $0 |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 139 | 133 | $0 |
| 87804 | Detection test by immunoassay with direct visual observation for influenza virus | 78 | 39 | $0 |
| 87400 | Detection test by immunoassay technique for influenza virus | 64 | 31 | $0 |
| 87426 | Detection test by immunoassay technique for severe acute respiratory syndrome coronavirus | 63 | 62 | $0 |
Insurance plans in this area (ZIP 73401)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Nurse Practitioner | OK | |
| Physician Assistant | OK | |
| Physician Assistant | KS | |
| Physician Assistant | OK | |
| Physician Assistant | OK | |
| Physician Assistant | OK | |
| - | OK |
Reviews
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