Individual provider Active NPI

Shannon Walter Schwenke

  • Anesthesiology Physician
  • Houston, TX
National Provider Identifier
1619504230
Registry record updated Aug 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
A194661 Issued in CA
Practice address
1 Baylor PLZ
Houston, TX 77030-3498
Phone
(713) 798-4951
NPI assigned
Mar 24, 2020
Last updated
Aug 6, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Anesthesiology Physician 207L00000X A194661 CA Primary

Addresses

Primary practice location

1 Baylor PLZ
Houston, TX 77030-3498

Mailing address

1527 Reed St
Philadelphia, PA 19146-4851
Phone (920) 621-6647

Other practice location 1

1527 Reed St
Philadelphia, PA 19146-4851
Phone (920) 621-6647

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20240820003195 CA Practitioner - Anesthesiology 9638617798 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cep America - Anesthesia PCGroup PAC ID 3678897915, 849 clinicians

Practice addresses (Care Compare)

1601 Ygnacio Valley Rd
Walnut Creek, CA 94598-3122
Phone (925) 939-3000

2000 Mowry Ave
Fremont, CA 94538-1716
Phone (510) 797-1111

2540 E St
Concord, CA 94520-1906
Phone (925) 682-8200

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A194661CAMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cep America - Anesthesia PC Anesthesiology CurrentSince Aug 12, 2024 Accepting new patients
Cep America - Anesthesia, PC Anesthesiology CurrentSince Aug 12, 2024 Accepting new patients
John Muir Trauma Physicians Billing Service Anesthesiology CurrentSince Jan 24, 2026 Accepting new patients

Locations

2100 Powell St
Ste 400
Emeryville, CA 94608
Phone (510) 350-2638

2000 Mowry Ave
Fremont, CA 94538
Phone (510) 793-6653

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 350-2663

1601 Ygnacio Valley Rd
Walnut Creek, CA 94598
Phone (925) 295-1545

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

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": "1585008000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722902400000",
    "number": "1619504230",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1527 REED ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191464851",
            "telephone_number": "920-621-6647"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 BAYLOR PLZ",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770303498",
            "telephone_number": "713-798-4951"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1527 Reed St",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191464851",
            "country_code": "US",
            "telephone_number": "920-621-6647",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SCHWENKE",
        "first_name": "SHANNON",
        "middle_name": "WALTER",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-03-24",
        "last_updated": "2024-08-06",
        "certification_date": "2024-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "CA",
            "license": "A194661",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.