Individual provider Active NPI

Shannon Leigh Dileo, PA-C

  • Physician Assistant
  • Cinnaminson, NJ
National Provider Identifier
1730703588
Registry record updated Nov 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
25MP00566400 Issued in NJ
Practice address
2210 Derby Dr
Cinnaminson, NJ 08077-4518
Phone
(609) 678-6776
NPI assigned
Jun 7, 2020
Last updated
Nov 4, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2024

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 25MP00566400 NJ Primary

Addresses

Primary practice location

2210 Derby Dr
Cinnaminson, NJ 08077-4518

Mailing address

1 Federal St # 200
Camden, NJ 08103-1088
Phone (856) 356-4924

Other practice location 1

3 Cooper Plz Rm 403
Camden, NJ 08103-1438
Phone (856) 342-2439

Other names 1

  • Shannon Leigh McCormick Former name

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210908001519 NJ Practitioner - Physician Assistant 0446656086 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Drexel University College of Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cooper Surgical Associates, PAGroup PAC ID 3274430764, 303 clinicians

Practice addresses (Care Compare)

1 Cooper PLZ
Camden, NJ 08103-1461

2 Cooper PLZ
Camden, NJ 08103-1461

2339 Route 70 W
Cherry Hill, NJ 08002-3315

3 Cooper PLZ
Camden, NJ 08103-1438

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
85.23 of 100Reported as group
Quality
77.64
Promoting interoperability
98
Improvement activities
40
Cost
68.41

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MP00566400NJMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Cooper Surgical Associates, PA CurrentSince Aug 2, 2021 Accepting new patients

Locations

3 Cooper Plz
Rm 104
Camden, NJ 08103
Phone (609) 963-6770

3 Cooper Plz
Rm 403
Camden, NJ 08103
Phone (856) 342-2270

3 Cooper Plz
Rm 411
Camden, NJ 08103
Phone (856) 342-2270

2339 Route 70 W
Ste 200
Cherry Hill, NJ 08002
Phone (856) 751-6464

221 Victoria St
Glassboro, NJ 08028
Phone (856) 536-1475

900 Centennial Blvd
Ste 203
Voorhees, NJ 08043
Phone (856) 325-6674

Interoperability endpoints

  • Direct secure messaging: smccormick111593@direct.cooperhealth.edu

Organizations & group practices 2

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.

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": "1591488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730678400000",
    "number": "1730703588",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 FEDERAL ST # 200",
            "city": "CAMDEN",
            "state": "NJ",
            "postal_code": "081031088",
            "telephone_number": "856-356-4924"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2210 DERBY DR",
            "city": "CINNAMINSON",
            "state": "NJ",
            "postal_code": "080774518",
            "telephone_number": "609-678-6776"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3 Cooper Plz Rm 403",
            "address_purpose": "LOCATION",
            "city": "Camden",
            "state": "NJ",
            "postal_code": "081031438",
            "country_code": "US",
            "telephone_number": "856-342-2439",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DILEO",
        "first_name": "SHANNON",
        "middle_name": "LEIGH",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-07",
        "last_updated": "2024-11-04",
        "certification_date": "2024-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NJ",
            "license": "25MP00566400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHANNON",
            "last_name": "MCCORMICK",
            "middle_name": "LEIGH",
            "credential": "PA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Cinnaminson, NJ

Sources for this page

Verify at the official NPI Registry.