Shannon Kelly Quackenbush, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

748921-1 Issued in NY

Practice address

1001 Main St Ste K-3502
Buffalo, NY 14203-1009

Phone

(716) 323-6658

NPI assigned

Apr 23, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in PA, NY2 enrollments

Enrollment records 2

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Other, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Premier Anesthesia of New York, P.C.Group PAC ID 7719041102, 50 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Upmc Chautauqua at Wca Hospital, Jamestown, NY, CCN 330239

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

State licenses

Practice roles

Locations

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.

• Premier Anesthesia of New York, P.C.

  • Anesthesiology Physician
  • Saranac Lake, NY
  • NPI 1063658961

  Nurse Anesthetist, Certified Registered

  Medicare reassignment Care Compare group NPD
• Great Lakes Anesthesiology, PC

  • Specialist
  • Buffalo, NY
  • NPI 1306852181

  PA

  Medicare reassignment NPD

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

• Upmc Chautauqua at Wca

  • Substance Use Disorder Rehabilitation Hospital Unit
  • Jamestown, NY
  • NPI 1568023687
  Care Compare affiliation
• Upmc Chautauqua at Wca

  • General Acute Care Hospital
  • Jamestown, NY
  • NPI 1770573222
  Care Compare affiliation

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

{
    "created_epoch": "1587600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754006400000",
    "number": "1730709486",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 MAIN ST # K3502",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142031009",
            "telephone_number": "716-323-6570"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 MAIN ST STE K-3502",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142031009",
            "telephone_number": "716-323-6658"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QUACKENBUSH",
        "first_name": "SHANNON",
        "middle_name": "KELLY",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-04-23",
        "last_updated": "2025-08-01",
        "certification_date": "2025-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "AZ",
            "license": "RN178240",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "PA",
            "license": "RN629994",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NY",
            "license": "748921-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cheng Qian, M.D.
• You-Wen Qian, MD
• Jingxin Qiu, MD PHD
• Corrina Victoria Quach, RPH
• Kim Quach, N.P.
• Quadrant Laboratories, LLC
• Rachel Quagliana, RN
• Elicia Quagliariello, CRNA
• Quality Care Home Aides
• Karen Anne Quarantillo, LMT

• Certified Registered Nurse Anesthetist in Buffalo, NY
• Providers in Buffalo, NY by specialty
• Certified Registered Nurse Anesthetist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.

Verify at the official NPI Registry.