NPIMap

Individual provider Active NPI

Shannon A McMeekin-Hagadorn, RPAC

  • Physician Assistant
  • Plattsburgh, NY
National Provider Identifier
1710920186
Registry record updated Jan 6, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
008398 Issued in NY
Practice address
159 Margaret St
Suite 105
Plattsburgh, NY 12901-1874
Phone
(518) 561-3377
Fax
(518) 563-7433
NPI assigned
Jun 14, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 6, 2010

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 008398 NY Primary

Addresses

Primary practice location

159 Margaret St
Suite 105
Plattsburgh, NY 12901-1874

Mailing address

159 Margaret St
Suite 105
Plattsburgh, NY 12901-1874
Phone (518) 561-3377

Other identifiers 1

IdentifierTypeStateIssuer
000A99768003OtherNYBLUE SHIELD NENY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060504000000 NY Practitioner - Physician Assistant 1254341555 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Champlain Valley Physicians Hospital Medical CenterGroup PAC ID 2769396878, 356 clinicians

Practice addresses (Care Compare)

206 Cornelia St
Plattsburgh, NY 12901-2779

75 Beekman St
Plattsburgh, NY 12901-1438
Phone (518) 562-7100

Hospital & facility affiliations

  • The University of Vermont Health Network - Champl Hospital, Plattsburgh, NY, CCN 330250
  • The University of Vermont Health Network-Alice Hy Hospital, Malone, NY, CCN 331321
  • Elizabethtown Community Hospital Hospital, Elizabethtown, NY, CCN 331302
  • Adirondack Medical Center - Saranac Lake Hospital, Saranac Lake, NY, CCN 330079

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
008398NYMDMental Health Counselor
8398NYMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Champlain Valley Physicians Hospital Medical Center Physician Assistant CurrentSince Dec 1, 2018 Accepting new patients
Beach Medical Services Past Accepting new patients
Randy S Stoloff MD Adult & Pediatric Asthma & Allery PLLC Past Accepting new patients
Adirondack Physical Therapy & Sports Rehab, PC Past Accepting new patients
Associated Community Action of the North East Adirondack Region, Inc. Past Accepting new patients

Locations

75 Beekman St
Plattsburgh, NY 12901
Phone (518) 562-7100

159 Margaret St
Ste 105
Plattsburgh, NY 12901
Phone (518) 561-3377

Interoperability endpoints

  • Direct secure messaging: shagadorn236461@direct.uvmhealth.org

Organizations & group practices 6

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.

Hospital & facility affiliations 6

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

NPI Registry JSON

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

{
    "created_epoch": "1150243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1262736000000",
    "number": "1710920186",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "159 MARGARET ST",
            "address_2": "SUITE 105",
            "city": "PLATTSBURGH",
            "state": "NY",
            "postal_code": "129011874",
            "telephone_number": "518-561-3377",
            "fax_number": "518-563-7433"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "159 MARGARET ST",
            "address_2": "SUITE 105",
            "city": "PLATTSBURGH",
            "state": "NY",
            "postal_code": "129011874",
            "telephone_number": "518-561-3377",
            "fax_number": "518-563-7433"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCMEEKIN-HAGADORN",
        "first_name": "SHANNON",
        "middle_name": "A",
        "credential": "RPAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-14",
        "last_updated": "2010-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "008398",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD NENY",
            "identifier": "000A99768003",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Plattsburgh, NY

Sources for this page

Verify at the official NPI Registry.