Jacqueline Shanahan, D.O

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

280972 Issued in NY

Practice address

3670 S Benzing Rd
Orchard Park, NY 14127

Phone

(716) 662-5357

NPI assigned

Aug 14, 2008

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in NY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Family Practice

Education

New York College of Osteo Medicine of New York Institute of Technology, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Buffalo Medical Group, P.C.Group PAC ID 7012820301, 233 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Bertrand Chaffee Hospital Hospital, Springville, NY, CCN 330111
• Mercy Hospital of Buffalo Hospital, Buffalo, NY, CCN 330279
• Sisters of Charity Hospital Hospital, Buffalo, NY, CCN 330078

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: production@direct.buffalomedicalgroup.com
• Direct secure messaging: jshanahan10890@direct.buffalomedicalgroup.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Buffalo Medical Group, P.C.

  • Family Medicine Physician
  • Williamsville, NY
  • NPI 1881659506
  Medicare reassignment Care Compare group NPD
• Buffalo Medical Group, P.C.

  • Durable Medical Equipment & Medical Supplies
  • Lockport, NY
  • NPI 1982566782
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Bertrand Chaffee Hospital

  • General Acute Care Hospital
  • Springville, NY
  • NPI 1275553521
  Care Compare affiliation
• Mercy Hospital of Buffalo

  • General Acute Care Hospital
  • Buffalo, NY
  • NPI 1164464921
  Care Compare affiliation
• Sisters of Charity Hospital of Buffalo New York

  • General Acute Care Hospital
  • Cheektowaga, NY
  • NPI 1043455199
  Care Compare affiliation
• Sisters of Charity Hospital of Buffalo New York

  • General Acute Care Hospital
  • Buffalo, NY
  • NPI 1790727543
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1218672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639353600000",
    "number": "1104072701",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "425 ESSJAY RD STE 170",
            "city": "WILLIAMSVILLE",
            "state": "NY",
            "postal_code": "142215782",
            "telephone_number": "716-630-1219"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3670 S BENZING RD",
            "city": "ORCHARD PARK",
            "state": "NY",
            "postal_code": "14127",
            "telephone_number": "716-662-5357"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3670 S Benzing Rd",
            "address_purpose": "LOCATION",
            "city": "Orchard Park",
            "state": "NY",
            "postal_code": "141271705",
            "country_code": "US",
            "telephone_number": "716-662-5357",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3900 N Buffalo St",
            "address_purpose": "LOCATION",
            "city": "Orchard Park",
            "state": "NY",
            "postal_code": "141271842",
            "country_code": "US",
            "telephone_number": "716-630-1000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHANAHAN",
        "first_name": "JACQUELINE",
        "name_prefix": "Dr.",
        "credential": "D.O",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-08-14",
        "last_updated": "2021-12-13",
        "certification_date": "2021-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "280972",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "production@direct.buffalomedicalgroup.com",
            "affiliation": "N",
            "address_1": "3900 N Buffalo St",
            "city": "Orchard Park",
            "state": "NY",
            "country_code": "US",
            "postal_code": "141271842",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Serenity Wellness Mental Health Counseling PLLC
• Christopher James Seufert, MSW
• Yasar Shad, MD
• Nadia Shairi
• Christopher M Shanahan, RPA-C
• Joanne M Shannon
• Erica Janelle Shaver
• Kelly Rae Shea, FNP
• Russell N Shefrin, PHD
• Joan Barbara Shelden, P.T.

• Family Medicine Physician in Orchard Park, NY
• Providers in Orchard Park, NY by specialty
• Family Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.