Shauna Marie Ketchum, RPA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

013457-1 Issued in NY

Practice address

300 West Ave
Brockport, NY 14420-1118

Phone

(585) 637-3905

Fax

(585) 637-4990

NPI assigned

Oct 21, 2009

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Shauna Marie McCorry Former name

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

Specialty

Physician Assistant

Education

Other, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

University of RochesterGroup PAC ID 5799699088, 960 clinicians

Oak Orchard Community Health Center, Inc.Group PAC ID 5496746927, 41 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Rochester Regional Health Home Care Home health agency, Rochester, NY, CCN 337066
• Strong Memorial Hospital Hospital, Rochester, NY, CCN 330285
• Rochester General Hospital Hospital, Rochester, NY, CCN 330125

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: shauna.ketchum@oochc.eclinicaldirectplus.com

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.

• Oak Orchard Community Health Center Inc.

  dba Oak Orchard Health

  • Federally Qualified Health Center (FQHC)
  • Brockport, NY
  • NPI 1598707812
  Medicare reassignment Care Compare group NPD
• University of Rochester

  • Internal Medicine Physician
  • Rochester, NY
  • NPI 1710226824
  Medicare reassignment Care Compare group NPD
• Oak Orchard Community Health Center Inc

  • Federally Qualified Health Center (FQHC)
  • Albion, NY
  • NPI 1407453244
  NPD
• University of Rochester

  dba Strong Memorial Hospital-University of Rochester

  • Community/Retail Pharmacy
  • Rochester, NY
  • NPI 1598476269
  NPD

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

• Genesee Region Home Care Association Inc.

  dba Rochester Regional Health Home Care

  • Home Health Agency
  • Rochester, NY
  • NPI 1801819271
  Care Compare affiliation
• University of Rochester

  dba Strong Memorial Hospital

  • General Acute Care Hospital
  • Rochester, NY
  • NPI 1346285657
  Care Compare affiliation
• University of Rochester

  • General Acute Care Hospital
  • Rochester, NY
  • NPI 1669126090
  Care Compare affiliation

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

{
    "created_epoch": "1256083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718323200000",
    "number": "1750617072",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 WEST AVE",
            "city": "BROCKPORT",
            "state": "NY",
            "postal_code": "144201118",
            "telephone_number": "585-637-3905",
            "fax_number": "585-637-4990"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 WEST AVE",
            "city": "BROCKPORT",
            "state": "NY",
            "postal_code": "144201118",
            "telephone_number": "585-637-3905",
            "fax_number": "585-637-4990"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KETCHUM",
        "first_name": "SHAUNA",
        "middle_name": "MARIE",
        "credential": "RPA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-10-21",
        "last_updated": "2024-06-14",
        "certification_date": "2024-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NY",
            "license": "013457-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHAUNA",
            "last_name": "MCCORRY",
            "middle_name": "MARIE",
            "credential": "RPA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Isabelle Joy Karpovich
• Manmadharao Kasaraneni, M.D.
• Pamela L Kaufman, LMHC CRC
• Abigail Kelley, MSN, FNP-C
• Christina LN Kemp, PT
• Alisa Kim, D.M.D.
• Shawna King, LPN
• Melissa Kingston, M.S. ORT/L
• Danielle L Kistler
• Rob Seth Kleinberg, PT

• Medical Physician Assistant in Brockport, NY
• Providers in Brockport, NY by specialty
• Medical Physician Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.