Shannon Boodhwani, AGNP-C

Primary specialty

Gerontology Nurse PractitionerTaxonomy code 363LG0600X

License

APRN11018802 Issued in FL

Practice address

2450 Goodlette-Frank Rd N Ste 101
Naples, FL 34103-4595

Phone

(239) 624-8470

NPI assigned

Feb 21, 2017

Last updated

Mar 14, 2024By the provider in NPPES

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 identifiers 2

Other names 1

• Shannon Willenberg Former name

Medicare fee-for-service enrollment

Enrolled in FL

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

Nurse Practitioner

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Nchmd IncGroup PAC ID 9436139565, 503 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Preferred Care Home Health Services Home health agency, Fort Myers, FL, CCN 109423
• Pinnacle Home Care Home health agency, Fort Myers, FL, CCN 683113
• Naples Community Hospital Hospital, Naples, FL, CCN 100018

Merit-based Incentive Payment System (MIPS)

Final score

95.25 of 100Reported as apm

Quality

87.73

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Networks

• Optimum HealthCare HMO Network
• Freedom Health HMO Network

Interoperability endpoints

• Direct secure messaging: sboodhwani50828@nchhealthcaresystem.direct-ci.com

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.

• Nchmd Inc

  • Hematology & Oncology Physician
  • Naples, FL
  • NPI 1831120195
  Medicare reassignment Care Compare group NPD
• Nchmd, Inc

  • Durable Medical Equipment & Medical Supplies
  • Naples, FL
  • NPI 1033904651
  NPD

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

• Naples Community Hospital Inc

  dba NCH Healthcare System Inc

  • General Acute Care Hospital
  • Naples, FL
  • NPI 1720085137
  Care Compare affiliation
• Pinnacle Home Care of SW Florida, LLC

  • Home Health Agency
  • Fort Myers, FL
  • NPI 1720592751
  Care Compare affiliation
• Providia Home Care LLC.

  dba Preferred Care Home Health Services

  • Home Health Agency
  • Fort Myers, FL
  • NPI 1245409010
  Care Compare affiliation

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

{
    "created_epoch": "1487635200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710374400000",
    "number": "1841739018",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2450 GOODLETTE-FRANK RD N STE 101",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "341034595",
            "telephone_number": "239-624-8470"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2450 GOODLETTE-FRANK RD N STE 101",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "341034595",
            "telephone_number": "239-624-8470"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOODHWANI",
        "first_name": "SHANNON",
        "credential": "AGNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-02-21",
        "last_updated": "2024-03-14",
        "certification_date": "2024-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "FL",
            "license": "APRN11018802",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "114708500",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FL BLUE",
            "identifier": "MI6GD",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHANNON",
            "last_name": "WILLENBERG",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Andrew Michael Bonett, M.D.
• Bonia Baptiste Adult Family Care Home
• Catherine Boniello, LCSW
• Bonnie Zonas MD
• Nizar Ismail Boodhwani, CRNA
• Emerson Eran Bookal, MD
• Kenneth Bookman, M.D.
• Brittany Bootka, BCBA
• Rebecca Lindy Bootka, PTA
• Karina Borda, DPT

• Gerontology Nurse Practitioner in Naples, FL
• Providers in Naples, FL by specialty
• Gerontology Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 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.