Shannon Leary, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

026969 Issued in NY

Practice address

7801 Myrtle Ave
Glendale, NY 11385-7439

Phone

(718) 386-8300

NPI assigned

Aug 4, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Physician Assistant

Education

Other, 2021

Medicare assignment

May accept Medicare assignment

Telehealth

Offers telehealth services

Group practices

Lefferts Medical Associates PCGroup PAC ID 6305839150, 17 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Networks

• Healthfirst Medicare Network H5989
• Healthfirst Medicare Network H3359
• Healthfirst Medicare Network H9678
• Healthfirst Medicare Network H1722

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.

• Lefferts Medical Associates PC

  • Internal Medicine Physician
  • New Hyde Park, NY
  • NPI 1700922150
  Medicare reassignment Care Compare group
• Glendale Family Medicine,PC

  • Family Medicine Physician
  • Glendale, NY
  • NPI 1346444734
  Medicare reassignment

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1628035200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628035200000",
    "number": "1477227338",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "132 VERBENA AVE",
            "city": "FLORAL PARK",
            "state": "NY",
            "postal_code": "110013045",
            "telephone_number": "516-327-5048"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7801 MYRTLE AVE",
            "city": "GLENDALE",
            "state": "NY",
            "postal_code": "113857439",
            "telephone_number": "718-386-8300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEARY",
        "first_name": "SHANNON",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-04",
        "last_updated": "2021-08-04",
        "certification_date": "2021-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "026969",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sabrina Laporta, LMHC
• Larry Rosenthal,DMD,PC
• Oliver Laureta, R.P.T.
• Rachel Lavoie
• Caroline Leal, M.S.
• Dana Letscher, OTR/L
• Dave Leung, M.D.
• Kwan Ting Leung
• Elizabeth Levinson
• Natalya Leviyeva, M.D.

• Physician Assistant in Glendale, NY
• Providers in Glendale, NY by specialty
• Physician Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.