Individual provider Active NPI

Shawn A Roussin, PAC

  • Medical Physician Assistant
  • Exeter, NH
National Provider Identifier
1417033408
Registry record updated Oct 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
0395 Issued in NH
Practice address
21 Hampton Rd BLDG 3
Exeter, NH 03833-4854
Phone
(603) 775-0000
Fax
(603) 778-2856
NPI assigned
Oct 31, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 16, 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 0395 NH Primary

Addresses

Primary practice location

21 Hampton Rd BLDG 3
Exeter, NH 03833-4854

Mailing address

4 Alumni Dr
Exeter, NH 03833-2118
Phone (603) 775-0000

Other identifiers 1

IdentifierTypeStateIssuer
3077688MedicaidNH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NH
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
I20050308000754 NH Practitioner - Physician Assistant 7214981703 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Core Physicians LLCGroup PAC ID 2769563253, 290 clinicians

Practice addresses (Care Compare)

1 Hampton Rd
Suite A306
Exeter, NH 03833-4848
Phone (603) 929-1195

20 Hampton Rd
Exeter, NH 03833-4823
Phone (603) 775-0000

212 Calef Hwy
Epping, NH 03042-2322
Phone (603) 777-1000

3 Alumni Dr
Exeter, NH 03833-2123

879 Lafayette Rd
Hampton, NH 03842-1258
Phone (603) 775-7405

96 Calef Hwy
Unit 6
Epping, NH 03042-2224
Phone (603) 693-2100

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
86.36 of 100Reported as apm
Quality
85.92
Promoting interoperability
78
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
395NHMDRegistered Dietitian
0395NHMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Core Physicians, LLC CurrentSince Dec 19, 2016 Accepting new patients
Seacoast Emergency Physicians PC Past Accepting new patients
Wentworth Douglass Physician Corporation Past Accepting new patients

Locations

212 Calef Hwy
Epping, NH 03042
Phone (603) 693-2100

4 Alumni Dr
Exeter, NH 03833
Phone (603) 580-7653

21 Hampton Rd
Exeter, NH 03833
Phone (603) 772-1436

3 Alumni Dr
Ste 301
Exeter, NH 03833
Phone (603) 658-1180

21 Hampton Rd
Bldg 3
Exeter, NH 03833

7 Holland Way
#1
Exeter, NH 03833

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 and National Provider Directory roles.

Hospital & facility affiliations 1

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": "1162252800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760572800000",
    "number": "1417033408",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 ALUMNI DR",
            "city": "EXETER",
            "state": "NH",
            "postal_code": "038332118",
            "telephone_number": "603-775-0000",
            "fax_number": "603-778-2856"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 HAMPTON RD BLDG 3",
            "city": "EXETER",
            "state": "NH",
            "postal_code": "038334854",
            "telephone_number": "603-775-0000",
            "fax_number": "603-778-2856"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROUSSIN",
        "first_name": "SHAWN",
        "middle_name": "A",
        "name_prefix": "Mr.",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-31",
        "last_updated": "2025-10-16",
        "certification_date": "2025-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NH",
            "license": "0395",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3077688",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Exeter, NH

Sources for this page

Verify at the official NPI Registry.