Individual provider Active NPI

Shannon Severino, PA-C

  • Physician Assistant
  • Bethlehem, PA
National Provider Identifier
1467820688
Registry record updated Mar 6, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
MA057820 Issued in PA
Practice address
801 Ostrum St
Bethlehem, PA 18015-1000
Phone
(484) 658-2366
Fax
(833) 329-4059
NPI assigned
Sep 3, 2015
Last updated
Mar 6, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 6, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 25MP00679300 NJ
Physician Assistant 363A00000X MA057820 PA Primary

Addresses

Primary practice location

801 Ostrum St
Bethlehem, PA 18015-1000

Mailing address

801 Ostrum St
Bethlehem, PA 18015-1000
Phone (484) 658-2366

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, NJ2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20160215002411 PA Practitioner - Physician Assistant 9032413893 Reassigns benefits to 7 organizations
I20240308003288 NJ Practitioner - Physician Assistant 9032413893 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
St Lukes Physician Group IncGroup PAC ID 6709798333, 2,161 clinicians

Practice addresses (Care Compare)

111 Route 715
Brodheadsville, PA 18322-7101
Phone (272) 212-0420

4311 Easton Ave
Bethlehem, PA 18020-1431
Phone (610) 954-3600

4379 Easton Ave
101 Family Prac Palmer
Bethlehem, PA 18020-1431
Phone (610) 814-2424

801 Ostrm St
Bethlehem, PA 18015-1000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
97.13 of 100Reported as apm
Quality
82.27
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MP00679300NJMDPhysician Assistant
MA057820PAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
St. Luke's Hospital - Anderson Campus CurrentSince Feb 16, 2025 Accepting new patients
Carbon - Schuylkill Community Hospital Inc CurrentSince Feb 16, 2025 Accepting new patients
GSL Hospital CurrentSince Feb 16, 2025 Accepting new patients
St. Luke's Hospital CurrentSince Feb 16, 2025 Accepting new patients
St. Luke's Quakertown Hospital CurrentSince Feb 16, 2025 Accepting new patients
St Luke's Hospital CurrentSince Feb 16, 2025 Accepting new patients
St. Luke's Hosptial CurrentSince Feb 16, 2025 Accepting new patients
St. Luke's Hospital Monroe Campus CurrentSince Feb 16, 2025 Accepting new patients
St. Luke's Warren Physician Group, PC CurrentSince Feb 1, 2024 Accepting new patients
The Carbon Schuylkill Community Hospital, Inc. CurrentSince Feb 16, 2025 Accepting new patients
St Luke's Physician Group Inc CurrentSince Mar 28, 2016 Accepting new patients
St. Luke's Physician Group, Inc. CurrentSince Mar 28, 2016 Accepting new patients
St. Luke's Warren Physician Group, PC Physician Assistant CurrentSince Feb 1, 2024 Accepting new patients
St. Luke's Physician Group, Inc. Past Accepting new patients

Locations

185 Roseberry St
Bldg 2ND
Phillipsburg, NJ 08865
Phone (908) 847-2619

200 Strykers Rd
Phillipsburg, NJ 08865
Phone (908) 847-1035

4311 Easton Ave
Bethlehem, PA 18020
Phone (610) 954-3600

111 Route 715
Brodheadsvlle, PA 18322
Phone (272) 212-0420

250 S 21st St
Easton, PA 18042
Phone (610) 250-4300

801 Ostrum St
Fountain Hill, PA 18015
Phone (610) 954-2200

1104 North St
Jim Thorpe, PA 18229
Phone (570) 325-2400

2650 Woodglen Rd
Pottsville, PA 17901
Phone (272) 639-5755

487 E Moorestown Rd
Wind Gap, PA 18091
Phone (484) 526-7850

Organizations & group practices 20

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

View all 20

Hospital & facility affiliations 7

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": "1441238400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1772755200000",
    "number": "1467820688",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 OSTRUM ST",
            "city": "BETHLEHEM",
            "state": "PA",
            "postal_code": "180151000",
            "telephone_number": "484-658-2366",
            "fax_number": "833-329-4059"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 OSTRUM ST",
            "city": "BETHLEHEM",
            "state": "PA",
            "postal_code": "180151000",
            "telephone_number": "484-658-2366",
            "fax_number": "833-329-4059"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEVERINO",
        "first_name": "SHANNON",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-09-03",
        "last_updated": "2026-03-06",
        "certification_date": "2026-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NJ",
            "license": "25MP00679300",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA057820",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bethlehem, PA

Sources for this page

Verify at the official NPI Registry.