Gregory D Shannon, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA13960 Issued in CA

Practice address

72780 Country Club Dr
BLDG B 203
Rancho Mirage, CA 92270-4126

Phone

(760) 674-3847

Fax

(760) 674-3845

NPI assigned

Aug 10, 2006

Last updated

Mar 7, 2023By the provider in NPPES

Sex

Male

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 CA

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, 1996

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Eisenhower Medical CenterGroup PAC ID 5890689657, 462 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Eisenhower Medical Center Hospital, Rancho Mirage, CA, CCN 050573

Merit-based Incentive Payment System (MIPS)

Final score

87.87 of 100Reported as group

Quality

85.37

Promoting interoperability

100

Improvement activities

40

Cost

74.18

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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

• Eisenhower Medical Center

  dba Eisenhower Health

  • General Acute Care Hospital
  • Rancho Mirage, CA
  • NPI 1013981554
  Medicare reassignment Care Compare group NPD (past)
• Eisenhower Medical Center

  dba Eisenhower Health

  • General Acute Care Hospital
  • Palm Springs, CA
  • NPI 1598008658
  NPD

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

• Eisenhower Medical Center

  dba Eisenhower Health

  • General Acute Care Hospital
  • Rancho Mirage, CA
  • NPI 1013981554
  Care Compare affiliation

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

{
    "created_epoch": "1155168000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1225049984",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "72780 COUNTRY CLUB DR",
            "address_2": "BLDG B 203",
            "city": "RANCHO MIRAGE",
            "state": "CA",
            "postal_code": "922704126",
            "telephone_number": "760-674-3847"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "72780 COUNTRY CLUB DR",
            "address_2": "BLDG B 203",
            "city": "RANCHO MIRAGE",
            "state": "CA",
            "postal_code": "922704126",
            "telephone_number": "760-674-3847",
            "fax_number": "760-674-3845"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHANNON",
        "first_name": "GREGORY",
        "middle_name": "D",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-10",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA13960",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Physician Assistant in Rancho Mirage, CA
• Providers in Rancho Mirage, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.