Individual provider Active NPI

Shannon M Lyon, RPA

  • Physician Assistant
  • San Francisco, CA
National Provider Identifier
1700895141
Registry record updated Sep 22, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA63373 Issued in CA
Practice address
2 Embarcadero Ctr
San Francisco, CA 94111-3823
Phone
(888) 663-6331
NPI assigned
Aug 5, 2006
Last updated
Sep 22, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 22, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA63373 CA Primary
Physician Assistant 363A00000X 011268 NY

Addresses

Primary practice location

2 Embarcadero Ctr
San Francisco, CA 94111-3823

Mailing address

1 Embarcadero Ctr Ste 1900
San Francisco, CA 94111-3723

Other practice location 1

530 Lytton Ave Fl 2
Palo Alto, CA 94301-1541
Phone (415) 663-5584

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20071213000189 NY Practitioner - Physician Assistant 9032209150 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ruby Medical PCGroup PAC ID 0446753297, 6 clinicians

Practice addresses (Care Compare)

12 W 120TH St
New York, NY 10027-6308
Phone (914) 461-5607

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
011268NYMDRegistered Dietitian
PA63373CAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Rochester General Hospital CurrentSince Dec 1, 2016 Accepting new patients
Planned Parenthood of Greater New York Inc PastSince Mar 30, 2021 Accepting new patients
Planned Parenthood of the Southern Finger Lakes Inc. PastSince Mar 5, 2016 Accepting new patients

Locations

2 Coulter Rd
Clifton Springs, NY 14432
Phone (315) 462-1472

1425 Portland Ave
Rochester, NY 14621
Phone (585) 922-3122

Interoperability endpoints

  • Direct secure messaging: shannon.lyon.1@17222.direct.athenahealth.com

Organizations & group practices 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1154736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790035200000",
    "number": "1700895141",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 EMBARCADERO CTR STE 1900",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941113723"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 EMBARCADERO CTR",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941113823",
            "telephone_number": "888-663-6331"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "530 Lytton Ave Fl 2",
            "address_purpose": "LOCATION",
            "city": "Palo Alto",
            "state": "CA",
            "postal_code": "943011541",
            "country_code": "US",
            "telephone_number": "415-663-5584",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LYON",
        "first_name": "SHANNON",
        "middle_name": "M",
        "credential": "RPA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-05",
        "last_updated": "2026-09-22",
        "certification_date": "2026-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA63373",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "011268",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Francisco, CA

Sources for this page

Verify at the official NPI Registry.