Shannon Maureen O'Connell, PA

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

Practice address

270-05 270TH Ave
New Hyde Park, NY 11040

Phone

(718) 470-7000

NPI assigned

Jul 16, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

John T Mather Memorial HospitalGroup PAC ID 1254237753, 176 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• John T Mather Memorial Hospital of Port Jefferson Hospital, Port Jefferson, NY, CCN 330185

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner, Physician Assistant

State licenses

Practice roles

Locations

Networks

• Healthfirst Medicare Network H9678
• Healthfirst Medicare Network H5989
• Healthfirst Medicare Network H1722
• Healthfirst Medicare Network H3359

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.

• John T. Mather Memorial Hospital

  • Critical Care Medicine (Internal Medicine) Physician
  • Port Jefferson, NY
  • NPI 1467249334
  Medicare reassignment Care Compare group NPD
• John T. Mather Memorial Hospital

  • Psychiatry Physician
  • Port Jefferson Station, NY
  • NPI 1376642371
  Medicare reassignment NPD (past)
• North Shore-Lij Medical PC

  • Urology Physician
  • Great Neck, NY
  • NPI 1053688572
  Medicare reassignment
• John T. Mather Memorial Hospital

  • Hospitalist Physician
  • Port Jefferson, NY
  • NPI 1932296316
  NPD
• North Shore - Lij Medical PC

  • Internal Medicine Physician
  • New Hyde Park, NY
  • NPI 1790043479
  NPD

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

• John T. Mather Memorial Hospital

  • General Acute Care Hospital
  • Port Jefferson, NY
  • NPI 1093718728
  Care Compare affiliation

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

{
    "created_epoch": "1594857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594857600000",
    "number": "1124636188",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 MCKINLEY AVE",
            "city": "FRANKLIN SQUARE",
            "state": "NY",
            "postal_code": "110103711",
            "telephone_number": "516-965-4573"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "270-05 270TH AVE",
            "city": "NEW HYDE PARK",
            "state": "NY",
            "postal_code": "11040",
            "telephone_number": "718-470-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'CONNELL",
        "first_name": "SHANNON",
        "middle_name": "MAUREEN",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-07-16",
        "last_updated": "2020-07-16",
        "certification_date": "2020-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• NYU Langone Hospitals
• Kelseigh O'Brien
• Melissa Sue O'Brien, PHARMD, BCACP
• Nicole O'Brien, R.D.
• Caitlin Maeve O'Connell, NP
• Catherine Anne O'Connor, AU.D
• Christopher J. O'Connor, PA
• Kaitlin O'Connor
• Kathleen Ann O'Connor, F.N.P.
• Lorraine M. O'Keefe, P.T.

• Medical Physician Assistant in New Hyde Park, NY
• Providers in New Hyde Park, NY by specialty
• Medical Physician Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2020; 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.