Shannon Ashley Mackey, PA

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

029209 Issued in NY

Practice address

530 E 72ND St
New York, NY 10021-4855

Phone

(212) 717-8282

Fax

(212) 717-9643

NPI assigned

Sep 20, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

North Shore-Lij Medical PCGroup PAC ID 3375701568, 6,374 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Long Island Jewish Medical Center Hospital, New Hyde Park, NY, CCN 330195

Merit-based Incentive Payment System (MIPS)

Final score

93.07 of 100Reported as apm

Quality

79.77

Promoting interoperability

88.77

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Networks

• Healthfirst Medicare Network H1722
• Healthfirst Medicare Network H5989
• Healthfirst Medicare Network H9678
• Healthfirst Medicare Network H3359

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.

• North Shore-Lij Medical PC

  • Urology Physician
  • Great Neck, NY
  • NPI 1053688572
  Medicare reassignment Care Compare group
• North Shore - Lij Medical PC

  • Internal Medicine Physician
  • New Hyde Park, NY
  • NPI 1790043479
  NPD

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

• Long Island Jewish Medical Center

  • General Acute Care Hospital
  • New Hyde Park, NY
  • NPI 1285641514
  Care Compare affiliation

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

{
    "created_epoch": "1663632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684886400000",
    "number": "1871216341",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "530 E 72ND ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100214855",
            "telephone_number": "212-717-8282"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "530 E 72ND ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100214855",
            "telephone_number": "212-717-8282",
            "fax_number": "212-717-9643"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACKEY",
        "first_name": "SHANNON",
        "middle_name": "ASHLEY",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-09-20",
        "last_updated": "2023-05-24",
        "certification_date": "2023-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "NY",
            "license": "1508066705",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NY",
            "license": "029209",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• C Ronald Mackenzie, M.D.
• Charles Hallam Mackenzie, HEALTH COACH
• Elyse Mackenzie, MD
• Megan Ashley Mackenzie, MD
• Julia E. Mackey
• Sophia Mackey
• Steven Lee Mackey, M.D.
• Joanne Mackie, LMHC
• David G Mackinnon, MD
• Erin Rose Mackinnon, NP

• Surgery Physician in New York, NY
• Providers in New York, NY by specialty
• Surgery Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2023; 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.