Shane Bannon

Primary specialty

Acute Care Nurse PractitionerTaxonomy code 363LA2100X

License

SP024901 Issued in PA

Practice address

1 Convention Ave
Philadelphia, PA 19104-4311

Phone

(800) 789-7366

NPI assigned

Nov 24, 2021

Sex

Male

Sole proprietor

Yes

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 PA

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

Nurse Practitioner

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

University of Penn-Medical GroupGroup PAC ID 6204730955, 3,433 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Hospital of Univ of Pennsylvania Hospital, Philadelphia, PA, CCN 390111

Merit-based Incentive Payment System (MIPS)

Final score

84.91 of 100Reported as group

Quality

73.58

Promoting interoperability

100

Improvement activities

40

Cost

76.13

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

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.

• University of Penn-Medical Group

  • Gynecologic Oncology Physician
  • Philadelphia, PA
  • NPI 1235527342

  Single Specialty

  Medicare reassignment Care Compare group NPD
• University of Penn-Medical Group

  • Pain Medicine (Anesthesiology) Physician
  • Philadelphia, PA
  • NPI 1306234414
  NPD
• University of Penn-Medical Group

  • Surgical Oncology Physician
  • Philadelphia, PA
  • NPI 1871981985
  NPD

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

• Hospital of the University of PA

  • Ambulatory Fertility Facility
  • Phila, PA
  • NPI 1033262316

  Hospital

  Care Compare affiliation
• Trustees of the University of Pennsylvania

  • General Acute Care Hospital
  • Philadelphia, PA
  • NPI 1851370910
  Care Compare affiliation

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

{
    "created_epoch": "1637712000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637712000000",
    "number": "1245997220",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "285 BIRCH DR",
            "city": "LAFAYETTE HILL",
            "state": "PA",
            "postal_code": "194442103"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 CONVENTION AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191044311",
            "telephone_number": "800-789-7366"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BANNON",
        "first_name": "SHANE",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-11-24",
        "last_updated": "2021-11-24",
        "certification_date": "2021-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "PA",
            "license": "SP024901",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ronald Stuart Banner, MD
• Ashley Sarah Bannerman-Martin, CRNP
• Erin Kayla Bannister, CPNP-PC
• Andrea Bannon, CRNP
• Pamela Dorothy Bannon, MD
• Elisa Bano, OD
• Kraig Y Bano, MPT CHT
• Esha Bansal, MD, MPH
• Nikhil Deep Bansal, OD
• Pallavi Bansal, DMD

• Acute Care Nurse Practitioner in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Acute Care Nurse Practitioner in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 24, 2021; 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.