Individual provider Active NPI

Shannel Kane, FNP-BC, MSN

  • Nurse Practitioner
  • Somerset, NJ
National Provider Identifier
1275383853
Registry record updated Jan 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
26NJ15038100 Issued in NJ
Practice address
145 Kingsberry Dr
Somerset, NJ 08873-4310
Phone
(732) 533-9048
NPI assigned
Mar 25, 2024
Last updated
Jan 13, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 13, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 26NJ15038100 NJ Primary
Medical-Surgical Registered Nurse 163WM0705X 26NJ15038100 NJ

Addresses

Primary practice location

145 Kingsberry Dr
Somerset, NJ 08873-4310

Mailing address

145 Kingsberry Dr
Somerset, NJ 08873-4310
Phone (732) 533-9048

Other practice location 1

225 Williamson St
Elizabeth, NJ 07202-3625
Phone (908) 994-5738

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20250107001475 NJ Practitioner - Nurse Practitioner 9436687209 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Barnabas Health Medical Group PCGroup PAC ID 9537316955, 1,027 clinicians

Practice addresses (Care Compare)

225 Williamson St
Elizabeth, NJ 07202-3625
Phone (888) 724-7123

94 Old Short Hills Rd
Livingston, NJ 07039-5672

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
26NJ15038100NJMDMedical-Surgical Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Barnabas Health Medical Group PC CurrentSince Nov 28, 2024 Accepting new patients
Azz Medical Associates PC CurrentSince Nov 4, 2024 Accepting new patients
Barnabas Health Medical Group PC CurrentSince Nov 28, 2024 Accepting new patients

Locations

225 Williamson St
Elizabeth, NJ 07202
Phone (908) 994-5204

1440 Pennington Rd
Ste 1
Ewing, NJ 08618
Phone (609) 422-7928

355 Grand St
Jersey City, NJ 07302
Phone (201) 915-2224

475 Route 70
Ste 101
Lakewood, NJ 08701
Phone (732) 364-8000

94 Old Short Hills Rd
Livingston, NJ 07039
Phone (973) 322-5400

1245 Whitehorse Mercerville Rd
Ste 418
Trenton, NJ 08619
Phone (609) 581-8111

Organizations & group practices 3

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.

Hospital & facility affiliations 4

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": "1711324800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736726400000",
    "number": "1275383853",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "145 KINGSBERRY DR",
            "city": "SOMERSET",
            "state": "NJ",
            "postal_code": "088734310",
            "telephone_number": "732-533-9048"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "145 KINGSBERRY DR",
            "city": "SOMERSET",
            "state": "NJ",
            "postal_code": "088734310",
            "telephone_number": "732-533-9048"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "225 Williamson St",
            "address_purpose": "LOCATION",
            "city": "Elizabeth",
            "state": "NJ",
            "postal_code": "072023625",
            "country_code": "US",
            "telephone_number": "908-994-5738",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KANE",
        "first_name": "SHANNEL",
        "credential": "FNP-BC, MSN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-03-25",
        "last_updated": "2025-01-13",
        "certification_date": "2025-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NJ",
            "license": "26NJ15038100",
            "primary": true
        },
        {
            "code": "163WM0705X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Medical-Surgical",
            "state": "NJ",
            "license": "26NJ15038100",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Somerset, NJ

Sources for this page

Verify at the official NPI Registry.