Individual provider Active NPI

Shannon Freedman, PA-C

  • Physician Assistant
  • Norwalk, CT
National Provider Identifier
1649737065
Registry record updated Aug 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
4387 Issued in CT
Practice address
34 Maple St
Norwalk, CT 06850-3894
Phone
(203) 852-2000
NPI assigned
Feb 21, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 4387 CT Primary

Addresses

Primary practice location

34 Maple St
Norwalk, CT 06850-3894

Mailing address

184 Summer St Apt 704
Stamford, CT 06901-2352
Phone (203) 984-3641

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20190426000345 CT Practitioner - Physician Assistant 6406198282 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
4387CTMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Norwalk Hospital Association CurrentSince May 1, 2019 Accepting new patients
Norwalk Hospital Association CurrentSince May 1, 2019 Accepting new patients
Danbury Hospital CurrentSince Mar 16, 2020 Accepting new patients
Danbury Hospital CurrentSince Mar 16, 2020 Accepting new patients

Locations

24 Hospital Ave
Danbury, CT 06810
Phone (203) 739-7118

20 Germantown Rd
Danbury, CT 06810
Phone (203) 739-4820

34 Maple St
Norwalk, CT 06850
Phone (203) 852-2000

520 West Ave
Norwalk, CT 06850
Phone (203) 852-2417

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1550707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629417600000",
    "number": "1649737065",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "184 SUMMER ST APT 704",
            "city": "STAMFORD",
            "state": "CT",
            "postal_code": "069012352",
            "telephone_number": "203-984-3641"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "34 MAPLE ST",
            "city": "NORWALK",
            "state": "CT",
            "postal_code": "068503894",
            "telephone_number": "203-852-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FREEDMAN",
        "first_name": "SHANNON",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-02-21",
        "last_updated": "2021-08-20",
        "certification_date": "2021-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CT",
            "license": "4387",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Norwalk, CT

Sources for this page

Verify at the official NPI Registry.