SHANE A KECK (MPA,PA-C) – Physician Assistant, NPI 1134308067
Physician Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
4,285 PHYSICIAN ASSISTANT in WA
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Provider Addresses for SHANE A KECK (MPA,PA-C)
3100, Carillon Point, Houghton, Kirkland, King County, Washington, 98033, United States
KIRKLAND, WA 980337306
Phone: (425) 576-1700
Fax: (425) 827-7725
Mailing address matches the actual address.
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 7 Open Payments records for all available years, with a total value of $365.
Total Amount is formed as General ($365) + Research ($0) + Ownership ($0) = $365.
Last reported payment date: 2024-10-07 • Largest payer in this snapshot: E.R. Squibb & Sons, L.L.C. ($255).
Total Amount
$365
General + Research + Ownership
Payments
7
Total payment records
General Amount
$365
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-10-07
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| E.R. Squibb & Sons, L.L.C. | $255 |
| ABBVIE INC. | $51 |
| GENZYME CORPORATION | $31 |
| Amgen Inc. | $15 |
| Novartis Pharmaceuticals Corporation | $13 |
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: 2008-09-02
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 |
|---|---|---|---|---|
| I20080902000254 | I | Physician Assistant | WA | 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 98033)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Physician Assistant | WA | |
| D E R M A T O L O G Y | OR | |
| D E R M A T O L O G Y | WA | |
| Physician Assistant | FL | |
| D E R M A T O L O G Y | WA | |
| Physician Assistant | WA | |
| Physician Assistant | WA |
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