Shanna M Gannon, PA-C

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

2318 Issued in CT

Practice address

2200 Whitney Ave Ste 270
Hamden, CT 06518-3694

Phone

(203) 281-7000

NPI assigned

Sep 21, 2009

Last updated

Feb 14, 2022By the provider in NPPES

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

• Shanna Nicole Miller Former name

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in CT

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

Physician Assistant

Education

Other, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

HHC Physician Services PLLCGroup PAC ID 9537573357, 140 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Midstate Medical Center Hospital, Meriden, CT, CCN 070017

Merit-based Incentive Payment System (MIPS)

Final score

95.41 of 100Reported as group

Quality

83.74

Promoting interoperability

100

Improvement activities

40

Cost

72.88

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: shanna.gannon@xdr.hhchealthdirect.org

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.

• HHC Physician Services, PLLC

  • Internal Medicine Physician
  • Branford, CT
  • NPI 1669075610
  Medicare reassignment Care Compare group
• Hartford Healthcare Medical Group Specialists, PLLC

  • Surgery Physician
  • Hartford, CT
  • NPI 1023584216

  Surgical

  Medicare reassignment NPD
• Hartford Healthcare Medical Group, Inc

  dba Hartford HealthCare Medical Group

  • Surgery Physician
  • Wethersfield, CT
  • NPI 1043561301
  Medicare reassignment NPD
• Hartford Hospital

  • General Acute Care Hospital
  • Hartford, CT
  • NPI 1770696643
  Medicare reassignment NPD
• Hartford Healthcare Medical Group Specialists LLC

  • Customized Equipment (DME)
  • Groton, CT
  • NPI 1295367068
  NPD
• Hartford Hospital

  • Surgery Physician
  • Hartford, CT
  • NPI 1407806391
  NPD
• Hartford Pathology Associates, P.C.

  • Anatomic Pathology & Clinical Pathology Physician
  • Hartford, CT
  • NPI 1063464477
  NPD
• HHC Physician Services, PLLC

  • Physical Medicine & Rehabilitation Physician
  • Branford, CT
  • NPI 1609530237
  NPD
• HHC Physician Services, PLLC

  • Pulmonary Disease Physician
  • Guilford, CT
  • NPI 1962212779
  NPD
• Ciardiello, Bonadies & Aversa Surgery Group, P.C.

  • Surgery Physician
  • Hamden, CT
  • NPI 1851576151
  NPD (past)

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

• Midstate Medical Center

  • General Acute Care Hospital
  • Meriden, CT
  • NPI 1427007848
  Care Compare affiliation
• Midstate Medical Center

  • General Acute Care Hospital
  • Meriden, CT
  • NPI 1669524187
  Care Compare affiliation

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

{
    "created_epoch": "1253491200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644796800000",
    "number": "1639403892",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2200 WHITNEY AVE STE 270",
            "city": "HAMDEN",
            "state": "CT",
            "postal_code": "065183694",
            "telephone_number": "203-281-7000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2200 WHITNEY AVE STE 270",
            "city": "HAMDEN",
            "state": "CT",
            "postal_code": "065183694",
            "telephone_number": "203-281-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GANNON",
        "first_name": "SHANNA",
        "middle_name": "M",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-09-21",
        "last_updated": "2022-02-14",
        "certification_date": "2022-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "CT",
            "license": "2318",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003023181",
            "state": "CT"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Shanna.Gannon@xdr.hhchealthdirect.org",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "2200 Whitney Ave Ste 270",
            "city": "Hamden",
            "state": "CT",
            "country_code": "US",
            "postal_code": "065183694",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "SHANNA",
            "last_name": "MILLER",
            "middle_name": "NICOLE",
            "credential": "PA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Surgical Physician Assistant in Hamden, CT
• Providers in Hamden, CT by specialty
• Surgical Physician Assistant in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2022; 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.