Peter Andrew Shannon, P.A.

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

5601005978 Issued in MI

Practice address

2070 Biddle Ave
Wyandotte, MI 48192-4080

Phone

(734) 225-9100

NPI assigned

Jun 20, 2011

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in MI

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, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Henry Ford Wyandotte HospitalGroup PAC ID 2264334499, 194 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Wyandotte Hospital and Medical Center Hospital, Wyandotte, MI, CCN 230146

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: aafcpaspac@aafc.gwaydirect.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.

• Henry Ford Wyandotte Hospital

  • Obstetrics & Gynecology Physician
  • Wyandotte, MI
  • NPI 1457586646
  Medicare reassignment Care Compare group NPD
• Henry Ford Wyandotte Hospital

  dba Henry Ford Health Center-Brownstown Pharmacy

  • Community/Retail Pharmacy
  • Brownstown TWP, MI
  • NPI 1356356984
  NPD
• Henry Ford Wyandotte Hospital

  • Certified Registered Nurse Anesthetist
  • Wyandotte, MI
  • NPI 1386685212
  NPD (past)

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

• Henry Ford Wyandotte Hospital

  dba Henry Ford Health Center Brownstown

  • Ambulatory Surgical Clinic/Center
  • Wyandotte, MI
  • NPI 1093901035

  Hospital

  Care Compare affiliation
• Henry Ford Wyandotte Hospital

  • General Acute Care Hospital
  • Wyandotte, MI
  • NPI 1992725352
  Care Compare affiliation

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

{
    "created_epoch": "1308528000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613433600000",
    "number": "1891081626",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "44727 ERIK PASS",
            "city": "PLYMOUTH",
            "state": "MI",
            "postal_code": "481703976",
            "telephone_number": "989-413-0862"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2070 BIDDLE AVE",
            "city": "WYANDOTTE",
            "state": "MI",
            "postal_code": "481924080",
            "telephone_number": "734-225-9100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHANNON",
        "first_name": "PETER",
        "middle_name": "ANDREW",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-06-20",
        "last_updated": "2021-02-16",
        "certification_date": "2021-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601005978",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "pshannon704494@direct.hfhs.org",
            "affiliation": "N",
            "address_1": "2070 Biddle Ave",
            "city": "Wyandotte",
            "state": "MI",
            "country_code": "US",
            "postal_code": "481924080",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Micka Sestito, LMT
• Kian Setayesh, MD
• Abby Sexton
• Elizabeth Shaheen, M.D.
• Tasneem Shaikh
• Peeyush Sharma, PT
• Vijay Krishan Sharma, M.D.
• Vipul K Sharma
• Richard James Sharon, M.D.
• Robert Alan Sharon, M.D.

• Physician Assistant in Wyandotte, MI
• Providers in Wyandotte, MI by specialty
• Physician Assistant in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2021; 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.