SHANE ANDREW KAVANAUGH M.S., LMHC
NPI 1356692792
Counselor - Mental Health in Ames, IA
About Shane Andrew Kavanaugh M.s., Lmhc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
SHANE ANDREW KAVANAUGH M.S., LMHC (NPI 1356692792) is an individual mental health provider in Ames, Iowa, licensed in Iowa (001560) and active in the NPI registry since September 2012. He is enrolled in Medicare PECOS and is a graduate of Other (2012).
NPPES Registry Identity
Specialties & Licenses
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Shane Andrew Kavanaugh M.s., Lmhc is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.
Medicare Billing Reassignment
Medicare enrollment records show Shane Kavanaugh reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Gresham, OR 97030
- Reassigned Medicare billing, Oregon and Washington enrollments
- Medicare enrollment name: Kaiser Foundation Health Plan Of The Northwest
- Also billed through NPI 1609171081 (Washington)
- 3,207 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Other Providers at the Same Location NPPES 20
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Shane Kavanaugh's NPI number?
The NPI number for Shane Kavanaugh is 1356692792. It was assigned to this individual provider in the NPPES registry on September 25, 2012.
Where is Shane Kavanaugh located?
Shane Kavanaugh practices at 125 S 3rd St, Ames, IA 50010. The listed phone number is (515) 661-4210.
What is Shane Kavanaugh's specialty?
The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.
Is Shane Kavanaugh enrolled in Medicare?
Yes. Shane Kavanaugh is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.
Which organization bills Medicare for Shane Kavanaugh's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Shane Kavanaugh reassigns Medicare benefits to Sapphire At Gresham Rehab, LLC (Gresham, OR). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Shane Kavanaugh's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Shane Kavanaugh accept?
Health plans from BridgeSpan Health Company, Kaiser Permanente, Moda Health Plan, Inc., PacificSource Health Plans and Regence BlueCross BlueShield of Oregon list Shane Kavanaugh as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for Shane Kavanaugh was last updated on March 13, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Shane Andrew Kavanaugh, M.S., LMHC · NPI 1356692792
Mental Health provider in Ames, Iowa. Individual provider, active in the CMS NPPES registry since September 25, 2012.
## Identity
- **NPI:** 1356692792 (Entity type: Individual)
- **Enumerated:** September 25, 2012
- **Primary specialty:** Counselor - Mental Health · taxonomy 101YM0800X
- **State license:** 001560 (Iowa)
- **Sole proprietor:** No
## Practice location
- **Address:** 125 S 3RD ST, Ames, IA 50010-7042
- **Phone:** (515) 661-4210
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment
- **Bills Medicare through:** Sapphire At Gresham Rehab, LLC (NPI 1033740899, Gresham, OR), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2012
## Record status
- **NPPES last updated:** March 13, 2015
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Source: [NPI Profile](https://npiprofile.com/npi/1356692792) · Data from the CMS NPPES public registry.