DR. KENNETH LEO SHAN MD
NPI 1629605431
Internal Medicine - Gastroenterology in Arcadia, CA
About Dr. Kenneth Leo Shan Md NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
DR. KENNETH LEO SHAN MD (NPI 1629605431) is an individual gastroenterology provider in Arcadia, California, licensed in California (185090) and active in the NPI registry since March 2020. He is enrolled in Medicare PECOS and is a graduate of University Of Iowa, Rj & L Carver College Of Medicine (2020).
NPPES Registry Identity
Specialties & Licenses
Group Practice 1
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
Dr. Kenneth Leo Shan Md 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 Kenneth Shan reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Arcadia, CA 91007
- Reassigned Medicare billing, California enrollment
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 91007 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Other Providers at the Same Location NPPES 3
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
ARCADIA, CA 91007
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 Kenneth Shan's NPI number?
The NPI number for Kenneth Shan is 1629605431. It was assigned to this individual provider in the NPPES registry on March 24, 2020.
Where is Kenneth Shan located?
Kenneth Shan practices at 612 W Duarte Rd Ste 601, Arcadia, CA 91007. The listed phone number is (818) 659-5887.
What is Kenneth Shan's specialty?
The primary specialty registered for this NPI is Internal Medicine, specializing in Gastroenterology, with taxonomy code 207RG0100X.
Is Kenneth Shan enrolled in Medicare?
Yes. Kenneth Shan 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 Kenneth Shan's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Kenneth Shan reassigns Medicare benefits to Kenneth Shan MD Inc (Arcadia, CA). 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 Kenneth Shan's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
When was this NPI record last updated?
The NPPES record for Kenneth Shan was last updated on March 12, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 months 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.
# Dr. Kenneth Leo Shan, MD · NPI 1629605431
Gastroenterology physician in Arcadia, California. Individual provider, active in the CMS NPPES registry since March 24, 2020.
## Identity
- **NPI:** 1629605431 (Entity type: Individual)
- **Enumerated:** March 24, 2020
- **Primary specialty:** Internal Medicine - Gastroenterology · taxonomy 207RG0100X
- **State license:** 185090 (California)
- **Sole proprietor:** Yes
## Practice location
- **Address:** 612 W DUARTE RD STE 601, Arcadia, CA 91007-9240
- **Phone:** (818) 659-5887 · **Fax:** (320) 640-1309
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** Kenneth Shan MD Inc (NPI 1770430464, Arcadia, CA), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** University Of Iowa, Rj & L Carver College Of Medicine, class of 2020
## Record status
- **NPPES last updated:** March 12, 2026
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Source: [NPI Profile](https://npiprofile.com/npi/1629605431) · Data from the CMS NPPES public registry.