MS. SHALYN M VANDERBLOEMEN (PA-C) – Physician Assistant, NPI 1861620114
Physician Assistant
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Doctor Profile
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Profile Insights
NPPES metrics only — not quality of care.
5,035 PHYSICIAN ASSISTANT in IL
Provider Addresses for MS. SHALYN M VANDERBLOEMEN (PA-C)
PO BOX 3808
PORTLAND, OR 972083808
Phone:
Type: Mailing
777 Park Ave W
Highland Park, IL 600352433
Phone: (847) 432-8000
Type: Location
3601 The Vanderbilt Clinic
Nashville, TN 372322433
Phone: (615) 322-3000
Type: Location
Highland Park Hospital, 777, Park Avenue West, Highland Park, Illinois, 60035, United States
HIGHLAND PARK, IL 600352433
Phone: (847) 432-8000
Type: Mailing
2222 NW LOVEJOY ST STE 606
PORTLAND, OR 972105104
Phone: (503) 413-5915
Type: Location
3841 GREEN HILLS VILLAGE DR STE 200
NASHVILLE, TN 372152691
Phone:
Type: Mailing
3601 THE VANDERBILT CLINIC
NASHVILLE, TN 372322433
Phone: (615) 322-3000
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 4 Open Payments records for all available years, with a total value of $415.
Total Amount is formed as General ($415) + Research ($0) + Ownership ($0) = $415.
Last reported payment date: 2024-12-24 • Largest payer in this snapshot: Inari Medical, Inc. ($213).
Total Amount
$415
General + Research + Ownership
Payments
4
Total payment records
General Amount
$415
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-24
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Inari Medical, Inc. | $213 |
| Aroa Biosurgery Incorporated | $202 |
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: 2025-04-17
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 3 Medicare enrollment records; no due dates published yet.
Enrollment records
3
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 |
|---|---|---|---|---|
| I20090806000292 | I | Physician Assistant | IL | TBD |
| I20210125000963 | I | Physician Assistant | TN | TBD |
| I20250417002265 | I | Physician Assistant | OR | 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 97208)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Pulmonary Disease, Internal Medicine | OR | |
| - | OR | |
| - | OR | |
| - | OR | |
| - | OR | |
| Pain Management | CA | |
| - | OR | |
| - | OR | |
| - | OR | |
| - | OR |
Reviews
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