Individual provider Active NPI

Christine K. Shanahan, PA-C

  • Physician Assistant
  • Norwalk, CT
National Provider Identifier
1194073049
Registry record updated May 8, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
002801 Issued in CT
Practice address
40 Cross St
Norwalk, CT 06851-4647
Phone
(203) 663-7978
NPI assigned
Aug 27, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 8, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 015868 NY
Physician Assistant 363A00000X 002801 CT Primary

Addresses

Primary practice location

40 Cross St
Norwalk, CT 06851-4647

Mailing address

40 Cross St
Ste 200
Norwalk, CT 06851-4647
Phone (203) 845-2160

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
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
I20161005001051 CT Practitioner - Physician Assistant 3476841578 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hartford Healthcare Medical Group Specialists PLLCGroup PAC ID 3173866241, 1,555 clinicians

Practice addresses (Care Compare)

1244 Storrs Rd
Road
Storrs, CT 06268-2200
Phone (860) 724-2579

32 Knight St
Suite 101
Norwalk, CT 06851-4707
Phone (203) 845-2460

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
90.42 of 100Reported as group
Quality
83.36
Promoting interoperability
100
Improvement activities
40
Cost
75.9

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2801CTMDProfessional Counselor
015868NYMDPsychologist
002801CTMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Hartford Healthcare Medical Group Specialists, PLLC CurrentSince Aug 17, 2020 Accepting new patients
SVMC Holdings, Inc CurrentSince May 19, 2023 Accepting new patients
Hartford Healthcare Medical Group Specialists LLC CurrentSince Aug 17, 2020 Accepting new patients
St Vincent'S Medical Center Past Accepting new patients

Locations

2800 Main St
Bridgeport, CT 06606
Phone (203) 386-0366

425 Post Rd
Ste 204
Fairfield, CT 06824
Phone (203) 254-1576

32 Knight St
Ste 101
Norwalk, CT 06851
Phone (203) 845-2460

32 Knight St
Ste 102
Norwalk, CT 06851
Phone (203) 845-2160

40 Cross St
Ste 200A
Norwalk, CT 06851
Phone (203) 845-2160

1244 Storrs Rd
Storrs Mansfield, CT 06268
Phone (860) 724-2579

1290 Silas Deane Hwy
Wethersfield, CT 06109
Phone (860) 972-6977

Interoperability endpoints

  • Direct secure messaging: christine.shanahan@xdr.hhchealthdirect.org

Organizations & group practices 4

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1346025600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1588896000000",
    "number": "1194073049",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40 CROSS ST",
            "address_2": "STE 200",
            "city": "NORWALK",
            "state": "CT",
            "postal_code": "068514647",
            "telephone_number": "203-845-2160"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40 CROSS ST",
            "city": "NORWALK",
            "state": "CT",
            "postal_code": "068514647",
            "telephone_number": "203-663-7978"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHANAHAN",
        "first_name": "CHRISTINE",
        "middle_name": "K.",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-08-27",
        "last_updated": "2020-05-08",
        "certification_date": "2020-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "015868",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CT",
            "license": "002801",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Norwalk, CT

Sources for this page

Verify at the official NPI Registry.