Individual provider Active NPI

Thomas Shannon Jr., D.P.M.

  • Foot & Ankle Surgery Podiatrist
  • Shillington, PA
National Provider Identifier
1821079864
Registry record updated Feb 25, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
SC-00567 Issued in PA
Practice address
654 Philadelphia Ave
Shillington, PA 19607-2769
Phone
(610) 796-9522
Fax
(610) 796-0105
NPI assigned
Nov 8, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 25, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X SC-00567 PA Primary

Addresses

Primary practice location

654 Philadelphia Ave
Shillington, PA 19607-2769

Mailing address

654 Philadelphia Ave
Shillington, PA 19607-2769
Phone (610) 796-9522

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100723000046 PA Practitioner - Podiatry 5294785440 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Kent State University College of Podiatric Medicine, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Berks Foot and Ankle Surgical Associates IncGroup PAC ID 8527030089, 8 clinicians

Practice addresses (Care Compare)

654 Philadelphia Ave
Shillington, PA 19607-2769
Phone (610) 796-9522

Hospital & facility affiliations

  • Reading Hospital Hospital, West Reading, PA, CCN 390044

Merit-based Incentive Payment System (MIPS)

Final score
80.1 of 100Reported as group
Quality
60.21
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue93
Removal of skin lesions1-10
Removal of nail tissue1946
Removal or shaving of skin growth630
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SC-00567PAMDFoot & Ankle Surgery Podiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Berks Foot and Ankle Surgical Associates, Inc Foot & Ankle Surgery CurrentSince Apr 16, 2002 Accepting new patients
Berks Foot and Ankle Surgical Associates, Inc Foot & Ankle Surgery CurrentSince Apr 16, 2002 Accepting new patients
The Reading Hospital Surgicenter at Spring Ridge LLC PastSince Aug 26, 2005 Accepting new patients

Locations

654 Philadelphia Ave
Shillington, PA 19607
Phone (610) 796-9522

Interoperability endpoints

  • Direct secure messaging: thomasshannondpm@bfasa.medentdirect.com

Organizations & group practices 3

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 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": "1131408000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1267056000000",
    "number": "1821079864",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "654 PHILADELPHIA AVE",
            "city": "SHILLINGTON",
            "state": "PA",
            "postal_code": "196072769",
            "telephone_number": "610-796-9522",
            "fax_number": "610-796-0105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "654 PHILADELPHIA AVE",
            "city": "SHILLINGTON",
            "state": "PA",
            "postal_code": "196072769",
            "telephone_number": "610-796-9522",
            "fax_number": "610-796-0105"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHANNON",
        "first_name": "THOMAS",
        "name_suffix": "Jr.",
        "credential": "D.P.M.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-08",
        "last_updated": "2010-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "PA",
            "license": "SC-00567",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shillington, PA

Sources for this page

Verify at the official NPI Registry.