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SHU DONG N.P.
NPI 1376842005
Nurse Practitioner in Banning, CA

Active since March 21, 2011PECOS Enrolled
86.35/100
CMS Quality Rating
12359 MALKI RD, BANNING, CA 92220(951) 922-2058(888) 551-2116 Get Directions Write a Review

NPPES record last updated: July 10, 2024. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Jul 10, 2024, Aug 12, 2020 (2 updates tracked since 2020).

About Shu Dong N.p. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SHU DONG N.P. (NPI 1376842005) is an individual nurse practitioner in Banning, California, licensed in California (20192) and active in the NPI registry since March 2011. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1376842005
Entity TypeIndividualFemale
Primary Taxonomy363L00000X
Provider Legal NameSHU DONGCredential: N.P.
Location Address12359 MALKI RDBanning, CA 92220-6974
Mailing Address12359 Malki RdBanning, CA 92220-6974 · (951) 922-2058 · Fax (888) 551-2116
Phone(951) 922-2058
Fax(888) 551-2116
Sole ProprietorNo
Enumeration DateMarch 21, 2011
Last NPPES UpdateJuly 10, 20242 updates tracked since enumeration
NPPES CertifiedJuly 10, 2024
✔ NPI 1376842005 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363L00000X
License✔ Licensed in CA · 20192
Definition
(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.
Also ListedNurse Practitioner · FamilyTaxonomy 363LF0000X · License 1117425 (TX)
12359 MALKI RD, Banning, CA 92220
Open in Google Maps ↗

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Texas.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Shu Dong N.p. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignments

3

Medicare enrollment records show Shu Dong reassigns Medicare billing to 3 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Physician Services Group Of Florida, LLC
1,753 mi
Family Medicine
3000 GULF BREEZE PKWY
Gulf Breeze, FL 32563
  • Reassigned Medicare billing, Florida enrollment
  • 79 clinicians in this Medicare group
NPI 1235775396 (850) 324-9633
Caringathome, LLC
2,072 mi
Internal Medicine
100 S ASHLEY DR STE 600
Tampa, FL 33602
  • Reassigned Medicare billing, Florida enrollment
  • 44 clinicians in this Medicare group
NPI 1912595828 (888) 553-2823
Careathome Medical Practice Ky
2,381 mi
Family Medicine
169 MADISON AVE STE 2817
New York, NY 10016
  • Reassigned Medicare billing, Texas enrollment
  • 41 clinicians in this Medicare group
NPI 1467040345 (888) 553-2823

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 9

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Complex chronic care management services for two or more chronic conditions, each additional 60 minutes of clinical staff time directed by health care professional, per calendar month 99489
Complex chronic care management is a service for patients with multiple chronic conditions. It involves an additional 60 minutes per month of clinical staff time directed by a healthcare professional. This service assists in managing your health conditions effectively.
503 services106 patients
Chronic care management services for two or more chronic conditions, additional 20 minutes of clinical staff time directed by health care professional, per calendar month 99439
Chronic Care Management services involve regular check-ins with healthcare professionals to manage two or more chronic conditions. It includes an additional 20 minutes of clinical staff time per month, directed by a healthcare professional, to ensure optimal health management.
260 services109 patients
Chronic care management services, first 20 minutes of clinical staff time directed by health care professional, per calendar month 99490
Chronic care management services involve a healthcare professional directing clinical staff in managing your chronic conditions. This includes the first 20 minutes per month of services like medication management, care coordination, and health monitoring to help improve your health and quality of life.
202 services121 patients
Complex chronic care management services for two or more chronic conditions, first 60 minutes of clinical staff time directed by health care professional, per calendar month 99487
Complex chronic care management is a service for patients with two or more long-term health conditions. It involves a healthcare professional directing clinical staff in providing care for the first 60 minutes each month. This helps manage your health conditions effectively.
153 services106 patients
Advance care planning, first 30 minutes 99497
Advance care planning is a process where you discuss your healthcare preferences with your doctor. This conversation, lasting up to 30 minutes, helps ensure your wishes are respected if you're unable to communicate them in the future. It's about your care, your way.
26 services26 patients
Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more 99215
This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.
22 services22 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 92220 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$91.88 typical visit price
range $59.60 – $179.42
Typical copayment $22.97 (range $14.90 – $44.85)
Most-billed visit code 99203
Established Patient
$104.64 typical visit price
range $19.37 – $146.42
Typical copayment $26.16 (range $4.84 – $36.60)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

86.35/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality77.06
Improvement Activities40
Cost90.15

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

FIRST AMERICANS MEDICAL GROUP, INC.
Family Medicine
12359 MALKI RD
BANNING, CA 92220
Riverside County (951) 922-2058

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 Shu Dong's NPI number?

The NPI number for Shu Dong is 1376842005. It was assigned to this individual provider in the NPPES registry on March 21, 2011.

Where is Shu Dong located?

Shu Dong practices at 12359 Malki Rd, Banning, CA 92220. The listed phone number is (951) 922-2058.

What is Shu Dong's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

Is Shu Dong enrolled in Medicare?

Yes. Shu Dong is registered in the Medicare PECOS enrollment system.

Which organizations bill Medicare for Shu Dong's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Shu Dong reassigns Medicare benefits to 3 organizations: Physician Services Group Of Florida, LLC (Gulf Breeze, FL), Caringathome, LLC (Tampa, FL) and Careathome Medical Practice Ky (New York, NY). Each 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 Shu Dong's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Shu Dong accept?

Health plans from Blue Cross and Blue Shield of Texas list Shu Dong 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 Shu Dong was last updated on July 10, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.