KEVIN SHI – Dermatology Physician, NPI 1033679824
Dermatology Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
1,284 DERMATOLOGY in TX
Provider Addresses for KEVIN SHI
5323 Harry Hines Blvd
Dallas, TX 753907201
Phone: (214) 999-9999
Type: Location
University of Texas Southwestern Medical Center, 5323, Harry Hines Boulevard, Dallas, TX, Dallas, Dallas County, Texas, 75390, United States
DALLAS, TX 753907201
Phone:
Type: Mailing
1450 PROFESSIONAL PARK DR STE 150
WINSTON SALEM, NC 271031307
Phone: (336) 724-2434
Type: Mailing
5 REGIONAL CIR # BC
PINEHURST, NC 283749863
Phone: (828) 322-7546
Fax: (828) 322-9927
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 $151.
Total Amount is formed as General ($151) + Research ($0) + Ownership ($0) = $151.
Last reported payment date: 2024-11-19 • Largest payer in this snapshot: Kerecis Limited ($69).
Total Amount
$151
General + Research + Ownership
Payments
4
Total payment records
General Amount
$151
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-11-19
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Kerecis Limited | $69 |
| SUN PHARMACEUTICAL INDUSTRIES INC. | $51 |
| Amgen Inc. | $31 |
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: 2024-05-06
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 |
|---|---|---|---|---|
| I20240506004497 | I | Dermatology | NC | 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 75390)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Physician Assistant | NC | |
| D E R M A T O L O G Y | NC | |
| Physician Assistant | FL | |
| Physician Assistant | NC | |
| Physician Assistant | NC | |
| Nurse Practitioner | NC | |
| Physician Assistant | NC | |
| Micrographic Dermatologic Surgery (Mds), Dermatology | NC | |
| Physician Assistant | NC | |
| Physician Assistant | NC |
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