Active NPI
Janine Shannon, RPA-C
- Surgical Physician Assistant
- Brooklyn, NY
National Provider Identifier
1568770675
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgical Physician Assistant
- License
- 014373
- Practice address
- 9711 3Rd Ave
Brooklyn, NY 11209-7702 - Phone
- (718) 833-1808
- Fax
- (718) 836-3711
- NPI assigned
- Sep 23, 2010
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgical Physician Assistant | 363AS0400X | 014373 | NY | Primary |
Addresses
Primary practice location
9711 3Rd Ave
Brooklyn, NY 11209-7702
Mailing address
9711 3Rd Ave
Brooklyn, NY 11209-7702
Phone (718) 833-1808
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | jshannon120180@nyumc.direct-ci.com | Direct |
Medicare participation
Medicare enrollment files- 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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2010
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
111 Broadway
New York, NY 10006-1901
Phone (212) 263-9700
150 55TH St
Brooklyn, NY 11220-2508
Phone (718) 630-7000
Hospital & facility affiliations
Merit-based Incentive Payment System (MIPS)
- Final score
- 90.8 of 100
- Quality
- 91.79
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 75.18
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 014373 | NY | MD | Surgical Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| New York University | Current | Accepting new patients | |
| New York University | Current | Accepting new patients |
Locations
9711 3rd Ave
Brooklyn, NY 11209
Phone (718) 833-1808
14 Wall St
Fl 9
Wall Street, NY 10005
Phone (646) 501-3224
Networks
- Healthfirst Medicare Network H9678
- Healthfirst Medicare Network H1722
- Healthfirst Medicare Network H3359
- Healthfirst Medicare Network H5989
Interoperability endpoints
- jshannon120180@nyumc.direct-ci.com
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.
-
- Physical Medicine & Rehabilitation Physician
- Boynton Beach, FL
- NPI 1104787613
Hospital & facility affiliations 7
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Rehabilitation Hospital Unit
- New York, NY
- NPI 1275632895
-
- General Acute Care Hospital
- Mineola, NY
- NPI 1427616002
-
- General Acute Care Hospital
- Brooklyn, NY
- NPI 1619341716
-
- General Acute Care Hospital
- New York, NY
- NPI 1669578324
-
- General Acute Care Hospital
- New York, NY
- NPI 1801992631
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1285200000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1617148800000",
"number": "1568770675",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9711 3RD AVE",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112097702",
"telephone_number": "718-833-1808",
"fax_number": "718-836-3711"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9711 3RD AVE",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112097702",
"telephone_number": "718-833-1808",
"fax_number": "718-836-3711"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHANNON",
"first_name": "JANINE",
"name_prefix": "Miss",
"credential": "RPA-C",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-09-23",
"last_updated": "2021-03-31",
"certification_date": "2021-03-31",
"status": "A"
},
"taxonomies": [
{
"code": "363AS0400X",
"taxonomy_group": "",
"desc": "Physician Assistant, Surgical",
"state": "NY",
"license": "014373",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "jshannon120180@nyumc.direct-ci.com",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"address_1": "9711 3rd Ave",
"city": "Brooklyn",
"state": "NY",
"country_code": "US",
"postal_code": "112097702",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Brooklyn, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 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.