DR. SHOKOUH PARDAKHTIM (DNP) – Licensed Practical Nurse, NPI 1396483392
Licensed Practical Nurse
Main info
Doctor Profile
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Profile Insights
NPPES metrics only — not quality of care.
6,261 NURSE PRACTITIONER in WA
Provider Addresses for DR. SHOKOUH PARDAKHTIM (DNP)
12039 NE 128TH ST STE 500
KIRKLAND, WA 980343029
Phone:
Type: Mailing
PO BOX 5127
EVERETT, WA 982065127
Phone: (206) 860-5414
Type: Mailing
904 7TH AVE
SEATTLE, WA 981041132
Phone: (206) 329-1760
Fax: (206) 720-7422
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: 2022-07-27
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 |
|---|---|---|---|---|
| I20220727003491 | I | Nurse Practitioner | 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.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 11105 | Punch biopsy, each additional skin growth | 44 | 22 | $0 |
| 11104 | Punch biopsy, first skin growth | 22 | 22 | $0 |
Insurance plans in this area (ZIP 98034)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| - | OR | |
| - | WA | |
| - | WA | |
| P A T H O L O G Y | TN | |
| Nurse Practitioner | WA | |
| Diagnostic Radiology | WA | |
| Nurse Practitioner | WA | |
| Physical Therapist In Private Practice | WA | |
| O T O L A R Y N G O L O G Y | WA | |
| Emergency Medicine | OR |
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