Individual provider Active NPI

Shannon Nye, PA

  • Gynecology Physician
  • Wellsville, NY
National Provider Identifier
1356048441
Registry record updated Nov 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gynecology PhysicianTaxonomy code 207VG0400X
License
032957 Issued in NY
Practice address
191 N Main St
Wellsville, NY 14895-1150
Phone
(585) 593-1100
NPI assigned
Feb 9, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 22, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gynecology Physician 207VG0400X 032957 NY Primary

Addresses

Primary practice location

191 N Main St
Wellsville, NY 14895-1150

Mailing address

35 Herman Ave
Wellsville, NY 14895-9513
Phone (585) 610-8009

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
I20250107002414 NY Practitioner - Physician Assistant 7911435706 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

127 N Main St
Wellsville, NY 14895-1149
Phone (585) 596-0145

Hospital & facility affiliations

  • Jones Memorial Hospital Hospital, Wellsville, NY, CCN 330096
  • St James Hospital Hospital, Hornell, NY, CCN 330151

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
032957NYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
The Memorial Hospital of William F. and Gertrude F. Jones, Inc. CurrentSince Dec 2, 2024 Accepting new patients
The Memorial Hospital of William F. and Gertrude F. Jones, Inc. CurrentSince Dec 2, 2024 Accepting new patients

Locations

73 Buffalo St
Ste 100
Canandaigua, NY 14424

7309 Seneca Rd N
Ste 114
Hornell, NY 14843
Phone (607) 324-0604

7309 Seneca Rd N
Ste 108
Hornell, NY 14843
Phone (607) 385-3790

191 N Main St
Wellsville, NY 14895
Phone (585) 593-1100

Interoperability endpoints

  • Direct secure messaging: snye227764@direct.urmc.rochester.edu

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 2

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": "1675900800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732233600000",
    "number": "1356048441",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "35 HERMAN AVE",
            "city": "WELLSVILLE",
            "state": "NY",
            "postal_code": "148959513",
            "telephone_number": "585-610-8009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "191 N MAIN ST",
            "city": "WELLSVILLE",
            "state": "NY",
            "postal_code": "148951150",
            "telephone_number": "585-593-1100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NYE",
        "first_name": "SHANNON",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-02-09",
        "last_updated": "2024-11-22",
        "certification_date": "2024-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VG0400X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": "NY",
            "license": "032957",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wellsville, NY

Sources for this page

Verify at the official NPI Registry.