SHANNON MEDLEY (P.A.-C) – Medical Physician Assistant, NPI 1376705806
Medical Physician Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
1,797 PHYSICIAN ASSISTANT in OK
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Provider Addresses for SHANNON MEDLEY (P.A.-C)
530 N MONTE VISTA
SUITE A
ADA, OK 748204675
Phone: (580) 436-7101
Fax: (580) 436-4447
Type: Mailing
1208, West 15th Street, Edmond, Oklahoma County, Oklahoma, 73013, United States
EDMOND, OK 730133001
Phone: (405) 340-2100
Fax: (405) 340-1184
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 14 Open Payments records for all available years, with a total value of $282.
Total Amount is formed as General ($282) + Research ($0) + Ownership ($0) = $282.
Last reported payment date: 2024-12-10 • Largest payer in this snapshot: Nevro Corp. ($94).
Total Amount
$282
General + Research + Ownership
Payments
14
Total payment records
General Amount
$282
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-10
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Nevro Corp. | $94 |
| Medtronic, Inc. | $44 |
| Saluda Medical Americas, Inc. | $30 |
| ABBVIE INC. | $24 |
| Astellas Pharma US Inc | $22 |
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: 2010-01-22
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 |
|---|---|---|---|---|
| I20100122000219 | 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 |
|---|---|---|---|---|
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 323 | 223 | $0 |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 190 | 148 | $0 |
Insurance plans in this area (ZIP 74820)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Physical Therapist In Private Practice | OK | |
| Physician Assistant | OK | |
| Anesthesiology, Pain Management | OK |
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