Shannon Marlene Denisoff, AGPCNP-BC

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

311144 Issued in NY

Practice address

100 Broad St
Glens Falls, NY 12801-4349

Phone

(518) 792-2223

Fax

(518) 792-8231

NPI assigned

Nov 16, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Shannon Marlene Farrell Former name

Electronic endpoints 2

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Hudson Headwaters Health NetworkGroup PAC ID 7416861208, 221 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Glens Falls Hospital Hospital, Glens Falls, NY, CCN 330191

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: shannon.denisoff.1@1823.direct.athenahealth.com
• Direct secure messaging: sfarrell792184@direct.trinity-health.org

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.

• Hudson Headwaters Health Network

  • Primary Care Clinic/Center
  • Warrensburg, NY
  • NPI 1194738344

  Nurse Practitioner

  Medicare reassignment Care Compare group NPD
• Hudson Headwaters Health Network

  • Primary Care Clinic/Center
  • Ticonderoga, NY
  • NPI 1952319386

  Nurse Practitioner

  NPD
• Hudson Headwaters Health Network

  • Primary Care Clinic/Center
  • Salem, NY
  • NPI 1982417119

  Nurse Practitioner

  NPD
• Eugene K. Merecki, MD PC

  • Primary Care Clinic/Center
  • Ballston Spa, NY
  • NPI 1962527630
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Glens Falls Hospital Inc

  • General Acute Care Hospital
  • Glens Falls, NY
  • NPI 1871606764
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1668556800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746748800000",
    "number": "1629787916",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9 CAREY RD",
            "city": "QUEENSBURY",
            "state": "NY",
            "postal_code": "128047880",
            "telephone_number": "518-761-0300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 BROAD ST",
            "city": "GLENS FALLS",
            "state": "NY",
            "postal_code": "128014349",
            "telephone_number": "518-792-2223",
            "fax_number": "518-792-8231"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3767 Main St",
            "address_purpose": "LOCATION",
            "city": "Warrensburg",
            "state": "NY",
            "postal_code": "128851890",
            "country_code": "US",
            "telephone_number": "518-623-2844",
            "fax_number": "518-623-3416",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DENISOFF",
        "first_name": "SHANNON",
        "middle_name": "MARLENE",
        "credential": "AGPCNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-11-16",
        "last_updated": "2025-05-09",
        "certification_date": "2025-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "311144",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "07551980",
            "state": "NY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "shannon.denisoff.1@1823.direct.athenahealth.com",
            "affiliation": "N",
            "address_1": "3767 Main St",
            "city": "Warrensburg",
            "state": "NY",
            "country_code": "US",
            "postal_code": "128851890",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "shannon.denisoff.1@1823.direct.athenahealth.com",
            "affiliation": "N",
            "address_1": "100 Broad St",
            "city": "Glens Falls",
            "state": "NY",
            "country_code": "US",
            "postal_code": "128014349",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "SHANNON",
            "last_name": "FARRELL",
            "middle_name": "MARLENE",
            "credential": "AGPCNP-BC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Mara Willis Dejonghe, M.S., CCC-SLP
• Joanne M. Della Valle, LCSW
• Andrew Delsignore
• Rachel Deluca
• Rebecca C Deluca, PT
• Pauline Dent
• Laura Depew
• Steven J Dercole
• Derek P Richardson,MD,PC
• Robert Daniel Desiderio, M.D.

• Adult Health Nurse Practitioner in Glens Falls, NY
• Providers in Glens Falls, NY by specialty
• Adult Health Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2025; 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.

Verify at the official NPI Registry.