KIRYL N SHADA PSYD
NPI 1841667797
Psychologist in Pleasant Prairie, WI

Active since August 26, 2015PECOS Enrolled
12500 AURORA DR, PLEASANT PRAIRIE, WI 53158(262) 857-5000(262) 857-5001 Get Directions Write a Review

NPPES record last updated: July 30, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Nov 16, 2022, Aug 31, 2022, Apr 14, 2022 (3 updates tracked since 2022).

About Kiryl N Shada Psyd NPPES

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

KIRYL N SHADA PSYD (NPI 1841667797) is an individual psychologist in Pleasant Prairie, Wisconsin, licensed in Wisconsin (22780) and active in the NPI registry since August 2015. She is enrolled in Medicare PECOS and maintains a secondary practice location in Portland.

NPPES Registry Identity

NPI1841667797
Entity TypeIndividualFemale
Primary Taxonomy103T00000X
Provider Legal NameKIRYL N SHADACredential: PSYD
Location Address12500 AURORA DRPleasant Prairie, WI 53158-1227
Mailing AddressPo Box 735044Chicago, IL 60673-5044 · (800) 326-2250
Fax(262) 857-5001
Sole ProprietorYes
Enumeration DateAugust 26, 2015
Last NPPES UpdateJuly 30, 20253 updates tracked since enumeration
NPPES CertifiedJuly 30, 2025
NPI 1841667797 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtyPsychologistBehavioral Health & Social Service Providers
Taxonomy Code103T00000X
License Licensed in WI · 22780
Definition
A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public.
Also ListedCounselor · Mental HealthTaxonomy 101YM0800X
12500 AURORA DR, Pleasant Prairie, WI 53158

Secondary Practice Location 1

Location 12130 SW Jefferson StPortland, OR 97201-7709 · Phone (262) 331-0169 · Fax (503) 297-5744

Other Identifiers 1

Medicaid100209168WI

Accepted Insurance

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare (PECOS)

Kiryl N Shada Psyd 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.

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.

Chiropractor
12500 AURORA DR
PLEASANT PRAIRIE, WI 53158
Physical Therapist
12500 AURORA DR
PLEASANT PRAIRIE, WI 53158
Physical Therapist
12500 AURORA DR
PLEASANT PRAIRIE, WI 53158
Nurse Practitioner
12500 AURORA DR
PLEASANT PRAIRIE, WI 53158
Physician Assistant
12500 AURORA DR
PLEASANT PRAIRIE, WI 53158
Physical Therapist
12500 AURORA DR
PLEASANT PRAIRIE, WI 53158
Physician Assistant
12500 AURORA DR
PLEASANT PRAIRIE, WI 53158
Surgery
12500 AURORA DR
PLEASANT PRAIRIE, WI 53158

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 Kiryl Shada's NPI number?

The NPI number for Kiryl Shada is 1841667797. It was assigned to this individual provider in the NPPES registry on August 26, 2015.

Where is Kiryl Shada located?

Kiryl Shada practices at 12500 Aurora Dr, Pleasant Prairie, WI 53158. The listed phone number is (262) 857-5000.

What is Kiryl Shada's specialty?

The primary specialty registered for this NPI is Psychologist with taxonomy code 103T00000X.

Is Kiryl Shada enrolled in Medicare?

Yes. Kiryl Shada is registered in the Medicare PECOS enrollment system.

What insurance does Kiryl Shada accept?

Health plans from Aspirus Health Plan, CareSource (Common Ground Healthcare), Medica, Quartz and UnitedHealthcare list Kiryl Shada 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 Kiryl Shada was last updated on July 30, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 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.