Individual provider Active NPI

Shannon Marie Viviano, D.O.

  • Emergency Medicine Physician
  • Grand Blanc, MI
National Provider Identifier
1497914378
Registry record updated Jun 5, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
5101017641 Issued in MI
Practice address
1 Genesys Pkwy
Grand Blanc, MI 48439-8065
Phone
(810) 606-5000
NPI assigned
Jun 5, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 5, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 5101017641 MI Primary

Addresses

Primary practice location

1 Genesys Pkwy
Grand Blanc, MI 48439-8065

Mailing address

1 Genesys Pkwy
Grand Blanc, MI 48439-8065
Phone (810) 606-5000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120718000351 MI Practitioner - Emergency Medicine 5597921627 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Beaumont Medical Group Hospital Based ServicesGroup PAC ID 3072875889, 575 clinicians

Practice addresses (Care Compare)

44201 Dequindre Rd
Troy, MI 48085-1117
Phone (248) 964-1187

44201 Dequindre Rd Ec
Beaumont Emergency Services TR
Troy, MI 48085-1117
Phone (248) 964-5111

Hospital & facility affiliations

  • Beaumont Hospital, Troy Hospital, Troy, MI, CCN 230269

Merit-based Incentive Payment System (MIPS)

Final score
89.64 of 100Reported as group
Quality
85.06
Promoting interoperability
100
Improvement activities
40
Cost
77.9

Merit-based Incentive Payment System (MIPS)

Final score
76.04 of 100Reported as group
Quality
67.93
Promoting interoperability
100
Improvement activities
40
Cost
52.21

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
Wellstreet Urgent Care of Michigan CurrentSince Aug 15, 2022 Accepting new patients
Beaumont Medical Group Hospital -Based Services CurrentSince Jul 21, 2018 Accepting new patients
Observation Medicine Group PLLC Emergency Medicine Past Accepting new patients
Wellstreet Urgent Care of Michigan PastSince Aug 6, 2023 Accepting new patients
Emergency Medicine Physicians of Genesee County, PLLC Emergency Medicine Past Accepting new patients

Locations

42757 Woodward Ave
Bloomfield Hills, MI 48304
Phone (248) 640-4751

3601 W 13 Mile Rd
Royal Oak, MI 48073

44201 Dequindre Rd
Troy, MI 48085
Phone (248) 471-8255

2078 E Big Beaver Rd
Troy, MI 48083
Phone (248) 855-4134

Interoperability endpoints

  • Direct secure messaging: sviviano1260319@epic00.shdirect.org

Organizations & group practices 5

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": "1212624000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1212624000000",
    "number": "1497914378",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 GENESYS PKWY",
            "city": "GRAND BLANC",
            "state": "MI",
            "postal_code": "484398065",
            "telephone_number": "810-606-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 GENESYS PKWY",
            "city": "GRAND BLANC",
            "state": "MI",
            "postal_code": "484398065",
            "telephone_number": "810-606-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VIVIANO",
        "first_name": "SHANNON",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-05",
        "last_updated": "2008-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MI",
            "license": "5101017641",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Blanc, MI

Sources for this page

Verify at the official NPI Registry.