Individual provider Active NPI

Shannon Anne Coleman, PA

  • Physician Assistant
  • Niagara Falls, NY
National Provider Identifier
1326569849
Registry record updated Jul 6, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
020920-1 Issued in NY
Practice address
533 10TH St
Niagara Falls, NY 14301-1870
Phone
(716) 278-4000
NPI assigned
Jul 6, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 6, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 020920-1 NY Primary

Addresses

Primary practice location

533 10TH St
Niagara Falls, NY 14301-1870

Mailing address

2320 Lockport Olcott Rd
Newfane, NY 14108-9514
Phone (716) 983-1347

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20170830000436 NY Practitioner - Physician Assistant 3476826272 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mount St. Marys Hospital of Niagara FallsGroup PAC ID 4082523790, 89 clinicians

Practice addresses (Care Compare)

5290 Military Rd
Suite 8
Lewiston, NY 14092-1953
Phone (716) 298-3000

5300 Military Rd
Lewiston, NY 14092-1903
Phone (716) 297-4800

Hospital & facility affiliations

  • McAuley Seton Home Care Corp Chha Home health agency, Buffalo, NY, CCN 337251
  • Mount St. Mary'S Hospital & Health Center Hospital, Lewiston, NY, CCN 330188
  • Niagara Falls Memorial Medical Center Hospital, Niagara Falls, NY, CCN 330065

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
020920-1NYMDPsychologist
020920NYMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Mount St. Mary'S Hospital of Niagara Falls CurrentSince Sep 16, 2024 Accepting new patients
Niagara Falls Memorial Medical Center CurrentSince Jun 24, 2017 Accepting new patients
Niagara Falls Memorial Medical Center CurrentSince Jun 24, 2017 Accepting new patients
Mount St. Mary'S Hospital of Niagara Falls Physician Assistant Past Accepting new patients

Locations

5290 Military Rd
Lewiston, NY 14092
Phone (716) 298-2321

533 10th St
Niagara Falls, NY 14301
Phone (716) 278-4151

621 10th St
North Falls, NY 14301
Phone (716) 278-4000

5300 Military Rd
Stela Niagara, NY 14092
Phone (716) 297-4800

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/3c975af8-28ae-4d97-adec-66228015b5a8/

Organizations & group practices 4

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 3

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": "1499299200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1499299200000",
    "number": "1326569849",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2320 LOCKPORT OLCOTT RD",
            "city": "NEWFANE",
            "state": "NY",
            "postal_code": "141089514",
            "telephone_number": "716-983-1347"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "533 10TH ST",
            "city": "NIAGARA FALLS",
            "state": "NY",
            "postal_code": "143011870",
            "telephone_number": "716-278-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLEMAN",
        "first_name": "SHANNON",
        "middle_name": "ANNE",
        "name_prefix": "Mrs.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-07-06",
        "last_updated": "2017-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "020920-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Niagara Falls, NY

Sources for this page

Verify at the official NPI Registry.