Shannon Wittel Kubis, PA-C
NPI 1407579238ActiveIndividual· Physician Assistant· Elgin, IL
Physician Assistant (PA-C) with Derick Dermatology PLLC, practicing in Elgin, Illinois. 316 Medicare patients in 2024, $62,489 paid; nearly all of their 443 Part D prescriptions were generic (95%). E.R. Squibb & Sons, L.L.C. reported $48.37 in payments in 2024, mostly food and beverage.
Overview
| NPI | 1407579238 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | PA-C |
| Sole proprietor | Yes |
| NPI issued | Sep 26, 2022 |
| Last updated in NPPES | Dec 26, 2024 |
| Certified by provider | Dec 26, 2024 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Physician Assistant Primary | 363A00000X | 085.009359 | IL |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Physician Assistant (IL) |
|---|---|
| Accepts assignment | Yes (participating) |
Medicare services in 2024
| Medicare patients | 316 |
|---|---|
| Services billed | 1,432 across 30 procedure codes |
| Paid by Medicare | $62,489 |
Part D prescriptions in 2024
| Prescriptions (claims) | 443 · 491 30-day fills |
|---|---|
| Patients | 172 |
| Total drug cost | $13,904 |
| Generic share | 95% of claims |
Education and affiliations
| Graduation year | 2022 |
|---|---|
| Medicare specialty | Physician Assistant |
Medical group
- Derick Dermatology PLLCArlington Heights, IL · 65 clinicians
Industry payments (Open Payments)
- 2024$48.37 · 1 payment from 1 company
Top paying companies in 2024
| Company | Amount | Payments |
|---|---|---|
| E.R. Squibb & Sons, L.L.C. | $48.37 | 1 |
What the 2024 payments were for
- Food and Beverage$48.37 · 1 payment
Receiving payments does not imply wrongdoing. What Open Payments covers ·original records
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