Individual provider Active NPI

Shannon McDermott Elliott, PA-C

  • Surgical Physician Assistant
  • Houston, TX
National Provider Identifier
1790443422
Registry record updated Nov 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
PA15204 Issued in TX
Practice address
2900 Richmond Ave
Houston, TX 77098-3106
Phone
(713) 363-2400
NPI assigned
Nov 30, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 30, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X PA15204 TX Primary

Addresses

Primary practice location

2900 Richmond Ave
Houston, TX 77098-3106

Mailing address

3111 Rowhouse LN
Houston, TX 77080-1109
Phone (832) 330-2598

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20220114002059 TX Practitioner - Physician Assistant 8820480239 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ut PhysiciansGroup PAC ID 8426960360, 1,744 clinicians

Practice addresses (Care Compare)

2900 Richmond Ave
Suite 200
Houston, TX 77098-3106
Phone (713) 512-6060

5420 W Loop S
Suite 2400
Bellaire, TX 77401-2107
Phone (713) 486-3550

5656 Kelley St
Houston, TX 77026-1967
Phone (713) 566-4635

6410 Fannin St
Houston, TX 77030-3005

6700 W Loop S
Bellaire, TX 77401-4122

950 Corbindale Rd
Suite 300
Houston, TX 77024-2849
Phone (713) 486-1700

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
84.11 of 100Reported as group
Quality
69.15
Promoting interoperability
100
Improvement activities
40
Cost
73.63

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA15204TXMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Ut Physicians CurrentSince Feb 14, 2022 Accepting new patients
Ut Physicians CurrentSince Feb 14, 2022 Accepting new patients

Locations

5420 West Loop S
Ste 2100
Bellaire, TX 77401
Phone (713) 486-0910

11476 Space Center Blvd
Ste 101
Houston, TX 77059

6411 Fannin St
Houston, TX 77030
Phone (713) 500-6200

6410 Fannin St
Ste 1508
Houston, TX 77030
Phone (713) 486-6130

6410 Fannin St
Ste 500
Houston, TX 77030
Phone (713) 500-5714

2900 Richmond Ave
Houston, TX 77098
Phone (713) 512-6194

11800 Astoria Blvd
Pearland, TX 77089
Phone (281) 929-6100

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 and National Provider Directory roles.

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": "1638230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638230400000",
    "number": "1790443422",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3111 ROWHOUSE LN",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770801109",
            "telephone_number": "832-330-2598"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2900 RICHMOND AVE",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770983106",
            "telephone_number": "713-363-2400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIOTT",
        "first_name": "SHANNON",
        "middle_name": "MCDERMOTT",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-11-30",
        "last_updated": "2021-11-30",
        "certification_date": "2021-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "TX",
            "license": "PA15204",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.