Active NPI
Shannon Nicole Evans
- Medical Physician Assistant
- Somerset, NJ
National Provider Identifier
1689187635
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Physician Assistant
- Practice address
- 59 Veronica Ave Ste 201
Somerset, NJ 08873-3579 - Phone
- (732) 828-0200
- NPI assigned
- Nov 13, 2017
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | Primary |
Addresses
Primary practice location
59 Veronica Ave Ste 201
Somerset, NJ 08873-3579
Mailing address
254 Easton Ave
New Brunswick, NJ 08901-1766
Phone (732) 745-8600
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NJ
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20191127000016 | NJ | Practitioner - Physician Assistant | 6507299807 | Reassigns benefits to 3 organizations |
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2019
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Saint Peter'S Healthcare System Physician Associates
Practice addresses (Care Compare)
240 Easton Ave
TRD FL Attn Man Care
New Brunswick, NJ 08901-1723
Phone (732) 565-5453
59 Veronica Ave
Somerset, NJ 08873-3579
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
Interoperability endpoints
- shannon.evans.1@8568.direct.athenahealth.com
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.
-
- General Practice Physician
- New Brunswick, NJ
- NPI 1548569361
NJ
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1510531200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1696291200000",
"number": "1689187635",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "254 EASTON AVE",
"city": "NEW BRUNSWICK",
"state": "NJ",
"postal_code": "089011766",
"telephone_number": "732-745-8600"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "59 VERONICA AVE STE 201",
"city": "SOMERSET",
"state": "NJ",
"postal_code": "088733579",
"telephone_number": "732-828-0200"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EVANS",
"first_name": "SHANNON",
"middle_name": "NICOLE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-11-13",
"last_updated": "2023-10-03",
"certification_date": "2023-08-10",
"status": "A"
},
"taxonomies": [
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Somerset, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 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.