SHELTON KNUDSEN (DO) – Emergency Medicine Physician, NPI 1104263425
Emergency Medicine Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
747 EMERGENCY MEDICINE in OK
Provider Addresses for SHELTON KNUDSEN (DO)
2906 N 17TH ST
BROKEN ARROW, OK 740129568
Phone: (405) 808-3214
Type: Mailing
744 W 9TH ST
TULSA, OK 741279020
Phone: (918) 599-1000
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: 2014-10-02
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 |
|---|---|---|---|---|
| I20141002001001 | I | Emergency Medicine | 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 |
|---|---|---|---|---|
| 99285 | Emergency department visit with high level of medical decision making | 318 | 308 | $0 |
| 99284 | Emergency department visit with moderate level of medical decision making | 120 | 117 | $0 |
| 99283 | Emergency department visit with low level of medical decision making | 18 | 18 | $0 |
| 99223 | Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes | 14 | 14 | $0 |
| 99238 | Hospital discharge day management, 30 minutes or less | 11 | 11 | $0 |
Insurance plans in this area (ZIP 74012)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| - | OK | |
| Emergency Medicine | OK | |
| Emergency Medicine | OK | |
| Emergency Medicine | OK | |
| Emergency Medicine, Family Practice | OK | |
| Pediatric Medicine | OK | |
| - | OK | |
| Emergency Medicine | OK | |
| Emergency Medicine | TX | |
| - | OK |
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