Individual provider Active NPI

Shannon Gayner, PA

  • Medical Physician Assistant
  • Manahawkin, NJ
National Provider Identifier
1285110015
Registry record updated May 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
25MP00475900 Issued in NJ
Practice address
115 E Bay Ave
Manahawkin, NJ 08050-3109
Phone
(609) 971-3300
Fax
(609) 597-4656
NPI assigned
Jul 16, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 12, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 25MP00475900 NJ Primary

Addresses

Primary practice location

115 E Bay Ave
Manahawkin, NJ 08050-3109

Mailing address

35 Beaverson Blvd Ste 8C
Brick, NJ 08723-7861
Phone (732) 262-4262

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
I20181130000130 NJ Practitioner - Physician Assistant 5890039994 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cardiovascular Associates of the Delaware Valley,P aGroup PAC ID 9032001284, 94 clinicians

Practice addresses (Care Compare)

1 Hwy 35
Keyport, NJ 07735-1166
Phone (732) 360-6333

210 W Atlantic Ave
Haddon Heights, NJ 08035-1715
Phone (856) 546-3003

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
86.51 of 100Reported as group
Promoting interoperability
82
Improvement activities
40

National Provider Directory

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

Organizations & group practices 2

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 9

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": "1531699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747008000000",
    "number": "1285110015",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "35 BEAVERSON BLVD STE 8C",
            "city": "BRICK",
            "state": "NJ",
            "postal_code": "087237861",
            "telephone_number": "732-262-4262",
            "fax_number": "732-262-4317"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 E BAY AVE",
            "city": "MANAHAWKIN",
            "state": "NJ",
            "postal_code": "080503109",
            "telephone_number": "609-971-3300",
            "fax_number": "609-597-4656"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAYNER",
        "first_name": "SHANNON",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-16",
        "last_updated": "2025-05-12",
        "certification_date": "2025-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NJ",
            "license": "25MP00475900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Manahawkin, NJ

Sources for this page

Verify at the official NPI Registry.