Individual provider Active NPI

Megan Elizabeth Shannon

  • Physical Therapist
  • Somerville, MA
National Provider Identifier
1174249494
Registry record updated Jul 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PTL27681 Issued in MA
Practice address
14 McGrath Hwy Unit 5
Somerville, MA 02143-4505
Phone
(617) 284-9418
NPI assigned
Oct 18, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 3, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PTL27681 MA Primary
Physical Therapist 225100000X 40QA02040400 NJ
Physical Therapist 225100000X 303348 CA

Addresses

Primary practice location

14 McGrath Hwy Unit 5
Somerville, MA 02143-4505

Mailing address

790 Remington Blvd
Bolingbrook, IL 60440-4909
Phone (866) 370-8206

Other practice location 1

703 Main St
Paterson, NJ 07503-2621
Phone (973) 754-2000

Other practice location 2

126 Avocado Ave Ste 107
Perris, CA 92571-2605
Phone (951) 943-8105

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address shannonm@sjhmc.org St. Joseph's University Medical Center

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
California Luna Care Physical Therapy PCGroup PAC ID 9638427834, 769 clinicians

Practice addresses (Care Compare)

16185 Los Gatos Blvd
Suite 205
Los Gatos, CA 95032-4569
Phone (866) 525-3175

Merit-based Incentive Payment System (MIPS)

Final score
85.19 of 100Reported as group
Quality
86.04
Improvement activities
40
Cost
76.23

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
40QA02040400NJMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Integrated Rehabilitation Group, PC Physical Therapist CurrentSince Apr 22, 2024 Accepting new patients
Integrated Rehabilitation Group, PC Physical Therapist CurrentSince Apr 22, 2024 Accepting new patients
Performance Rehabilitation of Western New England LLC Physical Therapist CurrentSince Aug 19, 2024 Accepting new patients
Rancho Physical Therapy, Inc. Physical Therapist CurrentSince Jan 1, 2023 Accepting new patients
MDRS Spine & Sport, Inc Physical Therapist CurrentSince Jun 19, 2023 Accepting new patients
Rancho Physical Therapy, Inc. Physical Therapist CurrentSince Jan 1, 2023 Accepting new patients
Performance Rehabilitation of Western New England LLC Physical Therapist CurrentSince Aug 19, 2024 Accepting new patients
Integrated Rehabilitation Group, PC Physical Therapist Current Accepting new patients
MDRS Spine & Sport, Inc Physical Therapist CurrentSince Jun 19, 2023 Accepting new patients
Carl Gustafson LLC Physical Therapist Past Accepting new patients

Locations

450 Rosewood Ave
Ste 105
Camarillo, CA 93010
Phone (805) 389-4781

1020 Tierra del Rey
Ste A1
Chula Vista, CA 91910
Phone (619) 585-7104

14150 Culver Dr
Ste 103
Irvine, CA 92604
Phone (949) 262-9142

600 Central Ave
Ste C
Lake Elsinore, CA 92530

126 Avocado Ave
Ste 107
Perris, CA 92571
Phone (951) 564-3080

9852 Business Park Dr
Ste A
Sacramento, CA 95827
Phone (916) 362-7962

5807 University Ave
Ste 6
San Diego, CA 92115
Phone (619) 500-0109

1801 Cleveland Ave
Ste B
Santa Rosa, CA 95401
Phone (707) 526-4180

29645 Rancho California Rd
Ste 121
Temecula, CA 92591
Phone (951) 676-0296

790 Remington Blvd
Bolingbrook, IL 60440

33377 Collection Ctr Dr
Chicago, IL 60693
Phone (617) 284-9418

101 University Dr
Ste A6
Amherst, MA 01002
Phone (413) 336-5703

14 McGrath Hwy
Unit 5
Somerville, MA 02143
Phone (617) 284-9418

10207 19th Ave SE
Everett, WA 98208
Phone (425) 337-3166

403 W Stanley St
Granite Falls, WA 98252
Phone (360) 691-4835

4220 132nd St SE
Ste 101
Mill Creek, WA 98012
Phone (425) 316-8046

13242 Aurora Ave N
Ste 103
Seattle, WA 98133
Phone (206) 420-0221

201 W North River Dr
Ste 510
Spokane, WA 99201
Phone (509) 323-0066

Organizations & group practices 11

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": "1666051200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719964800000",
    "number": "1174249494",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "790 REMINGTON BLVD",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604404909",
            "telephone_number": "866-370-8206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14 MCGRATH HWY UNIT 5",
            "city": "SOMERVILLE",
            "state": "MA",
            "postal_code": "021434505",
            "telephone_number": "617-284-9418"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "703 Main St",
            "address_purpose": "LOCATION",
            "city": "Paterson",
            "state": "NJ",
            "postal_code": "075032621",
            "country_code": "US",
            "telephone_number": "973-754-2000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "126 Avocado Ave Ste 107",
            "address_purpose": "LOCATION",
            "city": "Perris",
            "state": "CA",
            "postal_code": "925712605",
            "country_code": "US",
            "telephone_number": "951-943-8105",
            "fax_number": "951-943-8106",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHANNON",
        "first_name": "MEGAN",
        "middle_name": "ELIZABETH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-10-18",
        "last_updated": "2024-07-03",
        "certification_date": "2024-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MA",
            "license": "PTL27681",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA02040400",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "303348",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "shannonm@sjhmc.org",
            "affiliation": "Y",
            "affiliationName": "St. Joseph's University Medical Center",
            "address_1": "703 Main St",
            "city": "Paterson",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "075032621",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Somerville, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • 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.