Shannon Kyle Kaneaster, M.D.

Primary specialty

Otolaryngology PhysicianTaxonomy code 207Y00000X

License

22929 Issued in OK

Practice address

5701 N Portland Ave
Suite 305
Oklahoma City, OK 73112-1678

Phone

(405) 604-4475

Fax

(405) 604-4480

NPI assigned

Feb 5, 2007

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OK

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Otolaryngology

Education

Tulane University School of Medicine, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Oklahoma Otolaryngology Associates LLCGroup PAC ID 9739136102, 15 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Integris Baptist Medical Center, Inc Hospital, Oklahoma City, OK, CCN 370028

Merit-based Incentive Payment System (MIPS)

Final score

0 of 100Reported as individual

Quality

0

Promoting interoperability

0

Improvement activities

0

Cost

0

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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 and National Provider Directory roles.

• Oklahoma Otolaryngology Associates, LLC

  • Specialist
  • Oklahoma City, OK
  • NPI 1124118773
  Medicare reassignment Care Compare group NPD
• Deaconess Physician Services LLC

  • Family Medicine Physician
  • Oklahoma City, OK
  • NPI 1427017862

  Otolaryngology

  NPD (past)
• Integris Baptist Medical Center Inc

  • General Acute Care Hospital
  • Oklahoma City, OK
  • NPI 1831103654
  NPD (past)
• Jackson County Memorial Hospital Authority

  • General Acute Care Hospital
  • Altus, OK
  • NPI 1093763781
  NPD (past)
• Oklahoma Otolaryngology Hearing Center Inc

  • Audiologist
  • Edmond, OK
  • NPI 1356788954
  NPD (past)

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

• Integris Baptist Medical Center Inc

  • Psychiatric Hospital Unit
  • Oklahoma City, OK
  • NPI 1598837221
  Care Compare affiliation
• Integris Baptist Medical Center Inc

  • Psychiatric Hospital Unit
  • Spencer, OK
  • NPI 1659443372
  Care Compare affiliation
• Integris Baptist Medical Center Inc

  • General Acute Care Hospital
  • Oklahoma City, OK
  • NPI 1831103654
  Care Compare affiliation
• Integris Baptist Medical Center Inc

  • Psychiatric Hospital Unit
  • Spencer, OK
  • NPI 1881760759
  Care Compare affiliation

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

{
    "created_epoch": "1170633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1464739200000",
    "number": "1275672529",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3033 NW 63RD ST",
            "address_2": "SUITE 152",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731163634",
            "telephone_number": "405-755-6651",
            "fax_number": "405-607-3559"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5701 N PORTLAND AVE",
            "address_2": "SUITE 305",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731121678",
            "telephone_number": "405-604-4475",
            "fax_number": "405-604-4480"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KANEASTER",
        "first_name": "SHANNON",
        "middle_name": "KYLE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-05",
        "last_updated": "2016-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "OK",
            "license": "22929",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200172670A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Paul J Kanaly, MD
• Sara Elizabeth Kanary, M.ED.
• Purvaj Reddy Kandula, MD, MS
• Caroline Marie Kane
• Maria Monina Kane, M.D.
• Brian James Kanelakos, MPT
• Chanseulki Kang
• Yubin Kang, M.D.
• Brandon L Kannady, MD
• Matthew John Kapeles, MD

• Otolaryngology Physician in Oklahoma City, OK
• Providers in Oklahoma City, OK by specialty
• Otolaryngology Physician in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2016; 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.