Active NPI
Shannon N Moreau, PA-C
- Medical Physician Assistant
- Biddeford, ME
National Provider Identifier
1629337902
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Physician Assistant
- License
- PA1327
- Practice address
- 61 Barra Rd
Biddeford, ME 04005-9459 - Phone
- (207) 283-1441
- NPI assigned
- May 8, 2012
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | 0900 | NH | |
| Medical Physician Assistant | 363AM0700X | PA1327 | ME | Primary |
Addresses
Primary practice location
61 Barra Rd
Biddeford, ME 04005-9459
Mailing address
PO Box 9746
Portland, ME 04104-5040
Phone (207) 791-3888
Other names 1
- Shannon N Records
Electronic endpoints 2
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | shannon.moreau.1@5857.direct.athenahealth.com | ||
| Direct Messaging Address | shannon.moreau.1@5857.direct.athenahealth.com |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in ME
- 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, 2011
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
153 US Route 1
Scarborough, ME 04074-9052
Phone (207) 799-8596
74 Baribeau Dr
Brunswick, ME 04011-3218
Phone (207) 798-4050
Hospital & facility affiliations
- Mainehealth Home Health and Hospice
- Mainehealth Maine Medical Center
- York Hospital
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA1327 | ME | MD | Medical Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Martin'S Point Health Care, Inc. | Current | Accepting new patients | |
| Seacoast Pathology Inc | Current | Accepting new patients |
Locations
61 Barra Rd
Biddeford, ME 04005
Phone (207) 283-1441
331 Veranda St
Portland, ME 04103
Phone (207) 774-5801
15 Hospital Dr
Ofc
York, ME 03909
Phone (207) 351-2478
15 Hospital Dr
York, ME 03909
Phone (207) 351-2478
5 Alumni Dr
Exeter, NH 03833
Phone (603) 580-6339
Interoperability endpoints
- https://api.platform.athenahealth.com/5857/brand/1/csg/1/fhir/r4
Organizations & group practices 3
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.
-
- Family Medicine Physician
- Portland, ME
- NPI 1366474611
-
- General Acute Care Hospital
- York, ME
- NPI 1376528398
-
- Clinical Medical Laboratory
- Exeter, NH
- NPI 1154651230
Hospital & facility affiliations 39
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Scarborough, ME
- NPI 1053647024
-
- General Acute Care Hospital
- Portland, ME
- NPI 1346267879
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1336435200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1699833600000",
"number": "1629337902",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 9746",
"city": "PORTLAND",
"state": "ME",
"postal_code": "041045040",
"telephone_number": "207-791-3888"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "61 BARRA RD",
"city": "BIDDEFORD",
"state": "ME",
"postal_code": "040059459",
"telephone_number": "207-283-1441"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOREAU",
"first_name": "SHANNON",
"middle_name": "N",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-05-08",
"last_updated": "2023-11-13",
"certification_date": "2023-11-13",
"status": "A"
},
"taxonomies": [
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "NH",
"license": "0900",
"primary": false
},
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "ME",
"license": "PA1327",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "shannon.moreau.1@5857.direct.athenahealth.com",
"affiliation": "N",
"address_1": "61 Barra Rd",
"city": "Biddeford",
"state": "ME",
"country_code": "US",
"postal_code": "040059459",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "shannon.moreau.1@5857.direct.athenahealth.com",
"affiliation": "N",
"address_1": "61 Barra Rd",
"city": "Biddeford",
"state": "ME",
"country_code": "US",
"postal_code": "040059459",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": [
{
"first_name": "SHANNON",
"last_name": "RECORDS",
"middle_name": "N",
"credential": "PA-C",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Biddeford, ME
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2023; 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.