NPIMap

Individual provider Active NPI

Shannon Falcon, MD

  • Diagnostic Radiology Physician
  • Tampa, FL
National Provider Identifier
1740475920
Registry record updated May 2, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
ME106718 Issued in FL
Practice address
12902 Magnolia Dr.
Tampa, FL 33612
Phone
(888) 860-2778
Fax
(813) 355-5099
NPI assigned
Sep 11, 2007
Last updated
May 2, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 2, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X ME106718 FL Primary

Addresses

Primary practice location

12902 Magnolia Dr.
Tampa, FL 33612

Mailing address

12902 Magnolia Dr.
Tampa, FL 33612
Phone (888) 860-2778

Other identifiers 3

IdentifierTypeStateIssuer
006305100MedicaidFL
14L46OtherFLBLUE CROSS BLUE SHIELD
P01135662OtherFLR&R MEDICARE

Other names 1

  • Shannon Reed Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20120731000314 FL Practitioner - Diagnostic Radiology 7113183419 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
University of South Florida College of Medicine, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

12902 Usf Magnolia Dr
Tampa, FL 33612-9416
Phone (888) 860-2778

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
88 of 100Reported as group
Quality
74.04
Promoting interoperability
100
Improvement activities
40
Cost
70.96

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME106718FLMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
H Lee Moffitt Cancer Ctr & Res Inst Life Time Cancer SCRN Ctr Inc Diagnostic Radiology CurrentSince Apr 24, 2013 Accepting new patients
North Brandon Imaging LLC Diagnostic Radiology Past Accepting new patients
North Brandon Imaging LLC Past Accepting new patients
Sun City Imaging LLC Past Accepting new patients
Florida Medical Clinic, LLC Past Accepting new patients
Sun City Imaging LLC Diagnostic Radiology Past Accepting new patients
Total Imaging-Parsons LLC Diagnostic Radiology Past Accepting new patients

Locations

12902 Usf Magnolia Dr
Tampa, FL 33612
Phone (813) 745-2720

Interoperability endpoints

  • Direct secure messaging: shannon.falcon@direct.moffitt.org

Organizations & group practices 7

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 1

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": "1189468800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1367452800000",
    "number": "1740475920",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12902 MAGNOLIA DR.",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "33612",
            "telephone_number": "888-860-2778"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12902 MAGNOLIA DR.",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "33612",
            "telephone_number": "888-860-2778",
            "fax_number": "813-355-5099"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FALCON",
        "first_name": "SHANNON",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-09-11",
        "last_updated": "2013-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "FL",
            "license": "ME106718",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "006305100",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "14L46",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "R&R MEDICARE",
            "identifier": "P01135662",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHANNON",
            "last_name": "REED",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Tampa, FL

Sources for this page

Verify at the official NPI Registry.