Individual provider Active NPI

Jason Samuel Shinners, DO

  • Family Medicine Physician
  • Stony Brook, NY
National Provider Identifier
1568082691
Registry record updated Aug 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
322275 Issued in NY
Practice address
101 Nicholls Road HSC Level 3
Stony Brook, NY 11794-1715
Phone
(631) 444-5858
Fax
(631) 444-1899
NPI assigned
Apr 18, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 322275 NY Primary

Addresses

Primary practice location

101 Nicholls Road HSC Level 3
Stony Brook, NY 11794-1715

Mailing address

3650 Joseph Siewick Dr Ste 400
Fairfax, VA 22033-1715
Phone (703) 391-2020

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, NY2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20231012002664 DC Practitioner - Family Practice 5294180196 Reassigns benefits to 2 organizations
I20240910004283 NY Practitioner - Family PracticePractitioner - Sports Medicine 5294180196 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Sports Medicine
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

100 Nicolls Rd
Stony Brook, NY 11794-0001
Phone (631) 444-5858

101 Nicolls Rd
Stony Brook, NY 11794-0001
Phone (631) 444-5858

Hospital & facility affiliations

  • Suny/Stony Brook University Hospital Hospital, Stony Brook, NY, CCN 330393

Merit-based Incentive Payment System (MIPS)

Final score
93.98 of 100Reported as apm
Quality
87.97
Promoting interoperability
100
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as apm
Quality
89.86
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Inova Health Care Services CurrentSince Jul 3, 2023 Accepting new patients
Stony Brook Family and Preventive Medicine, University Faculty Practic Family Medicine CurrentSince Aug 26, 2024 Accepting new patients
Inova Physician Partners, LLC Family Medicine CurrentSince Jul 3, 2023 Accepting new patients
Inova Health Care Services CurrentSince Jul 3, 2023 Accepting new patients
Inova Physician Partners, Inc. - Specialists Past Accepting new patients

Locations

4 Smith Haven Mall
Ste 202
Lake Grove, NY 11755
Phone (631) 444-5858

100 Nicolls Rd
Stony Brook, NY 11794
Phone (631) 444-1560

3914 Centreville Rd
Ste 250
Chantilly, VA 20151
Phone (703) 435-1223

3650 Joseph Siewick Dr
Ste 400
Fairfax, VA 22033
Phone (703) 391-2020

3300 Gallows Rd
Fl 1
Falls Church, VA 22042
Phone (703) 776-4005

Networks

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

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 6

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": "1587168000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723680000000",
    "number": "1568082691",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3650 JOSEPH SIEWICK DR STE 400",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220331715",
            "telephone_number": "703-391-2020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 NICHOLLS ROAD HSC LEVEL 3",
            "city": "STONY BROOK",
            "state": "NY",
            "postal_code": "117941715",
            "telephone_number": "631-444-5858",
            "fax_number": "631-444-1899"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHINNERS",
        "first_name": "JASON",
        "middle_name": "SAMUEL",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-04-18",
        "last_updated": "2024-08-15",
        "certification_date": "2024-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "322275",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stony Brook, NY

Sources for this page

Verify at the official NPI Registry.