Individual provider Active NPI

Shannon Carey

  • Physician Assistant
  • Pittsfield, MA
National Provider Identifier
1497294615
Registry record updated Feb 21, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA6053 Issued in MA
Practice address
725 North St
Pittsfield, MA 01201-4109
Phone
(413) 447-2000
NPI assigned
Feb 21, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 21, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA6053 MA Primary

Addresses

Primary practice location

725 North St
Pittsfield, MA 01201-4109

Mailing address

38 Jason St
Pittsfield, MA 01201-5904

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
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
I20200512003146 CT Practitioner - Physician Assistant 5890071088 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hartford Healthcare Medical Group Specialists PLLCGroup PAC ID 3173866241, 1,555 clinicians

Practice addresses (Care Compare)

1244 Storrs Rd
Road
Storrs, CT 06268-2200
Phone (860) 724-2579

1290 Silas Deane Hwy
Wethersfield, CT 06109-4337
Phone (860) 827-7695

136 S Main St
West Hartford, CT 06107-3451
Phone (860) 246-2071

85 Seymour St
Hartford, CT 06106-5501
Phone (860) 696-4306

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
004781CTMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Hartford Healthcare Medical Group Specialists LLC CurrentSince Jun 8, 2020 Accepting new patients
Hartford Healthcare Medical Group Specialists, PLLC CurrentSince Jun 8, 2020 Accepting new patients

Locations

85 Seymour St
Ste 415
Hartford, CT 06106
Phone (860) 249-2071

376 Tolland Tpke
Ste 202
Manchester, CT 06042
Phone (860) 696-4923

1559 Sullivan Ave
South Windsor, CT 06074
Phone (860) 696-2350

1244 Storrs Rd
Storrs Mansfield, CT 06268
Phone (860) 724-2579

1290 Silas Deane Hwy
Wethersfield, CT 06109
Phone (860) 972-6977

Interoperability endpoints

  • Direct secure messaging: shannon.carey@xdr.hhchealthdirect.org

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.

NPI Registry JSON

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

{
    "created_epoch": "1487635200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1487635200000",
    "number": "1497294615",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "38 JASON ST",
            "city": "PITTSFIELD",
            "state": "MA",
            "postal_code": "012015904"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "725 NORTH ST",
            "city": "PITTSFIELD",
            "state": "MA",
            "postal_code": "012014109",
            "telephone_number": "413-447-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAREY",
        "first_name": "SHANNON",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-02-21",
        "last_updated": "2017-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MA",
            "license": "PA6053",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pittsfield, MA

Sources for this page

Verify at the official NPI Registry.