Individual provider Active NPI

Aaron Michael Shanahan, NP

  • Adult Health Nurse Practitioner
  • Buffalo, NY
National Provider Identifier
1447511530
Registry record updated Mar 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
3111108 Issued in NY
Practice address
564 Niagara St
Buffalo, NY 14201-1108
Phone
(716) 361-7684
NPI assigned
Jun 5, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 22, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 3111108 NY Primary

Addresses

Primary practice location

564 Niagara St
Buffalo, NY 14201-1108

Mailing address

564 Niagara St
Buffalo, NY 14201-1108
Phone (716) 361-7684

Other practice location 1

4298 Oakwood Ave
Blasdell, NY 14219-1223
Phone (716) 467-4799

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
I20230308001348 NY Practitioner - Nurse Practitioner 9032582242 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wny House Physician PLLCGroup PAC ID 0345663209, 2 clinicians

Practice addresses (Care Compare)

60 Brynstone CT
Amherst, NY 14228-3703
Phone (716) 345-6960

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
3111108NYMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Wny House Physician PLLC CurrentSince Nov 1, 2024 Accepting new patients
Urban Family Practice PC CurrentSince May 1, 2023 Accepting new patients
Care Medical Practice PLLC Adult Health CurrentSince Feb 1, 2023 Accepting new patients

Locations

2300 N St NW
Ste 200
Washington, DC 20037
Phone (844) 401-4663

564 Niagara St
Buffalo, NY 14201
Phone (716) 768-7700

564 Niagara St
Bldg 2
Buffalo, NY 14201
Phone (716) 324-5026

Interoperability endpoints

  • Direct secure messaging: ashanahan@wnyhousephysician.medentdirect.com

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 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": "1338854400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679443200000",
    "number": "1447511530",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "564 NIAGARA ST",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142011108",
            "telephone_number": "716-361-7684"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "564 NIAGARA ST",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142011108",
            "telephone_number": "716-361-7684"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4298 Oakwood Ave",
            "address_purpose": "LOCATION",
            "city": "Blasdell",
            "state": "NY",
            "postal_code": "142191223",
            "country_code": "US",
            "telephone_number": "716-467-4799",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHANAHAN",
        "first_name": "AARON",
        "middle_name": "MICHAEL",
        "name_prefix": "Mr.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-06-05",
        "last_updated": "2023-03-22",
        "certification_date": "2023-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "3111108",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Buffalo, NY

Sources for this page

Verify at the official NPI Registry.