Individual provider Active NPI

Shannon Renee Snyder, PA-C

  • Physician Assistant
  • West Palm Beach, FL
National Provider Identifier
1164668448
Registry record updated May 2, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9104871 Issued in FL
Practice address
1411 N Flagler Dr
Suite 6100
West Palm Beach, FL 33401-3404
Phone
(561) 655-4450
Fax
(561) 655-4469
NPI assigned
Dec 17, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 2, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA9104871 FL Primary

Addresses

Primary practice location

1411 N Flagler Dr
Suite 6100
West Palm Beach, FL 33401-3404

Mailing address

1411 N Flagler Dr
Suite 6100
West Palm Beach, FL 33401-3404
Phone (561) 655-4450

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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

Enrollment IDStateProvider typePAC IDDetails
I20120323000254 FL Practitioner - Physician Assistant 5294995593 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Institute for Asthma and Allergy PCGroup PAC ID 5496719213, 13 clinicians

Practice addresses (Care Compare)

840 US Hwy 1
Suite 235
North Palm Beach, FL 33408-3835
Phone (301) 962-5800

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1229472000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1335916800000",
    "number": "1164668448",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1411 N FLAGLER DR",
            "address_2": "SUITE 6100",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334013404",
            "telephone_number": "561-655-4450",
            "fax_number": "561-655-4469"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1411 N FLAGLER DR",
            "address_2": "SUITE 6100",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334013404",
            "telephone_number": "561-655-4450",
            "fax_number": "561-655-4469"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SNYDER",
        "first_name": "SHANNON",
        "middle_name": "RENEE",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-12-17",
        "last_updated": "2012-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9104871",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Palm Beach, FL

Sources for this page

Verify at the official NPI Registry.