Shane R O'Neil, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

016116 Issued in NY

Practice address

302 Reynolds Rd Ste a
Johnson City, NY 13790-1308

Phone

(607) 444-5446

Fax

(607) 444-5447

NPI assigned

Oct 12, 2012

Last updated

Oct 9, 2025By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

New Season Dermatology PLLCGroup PAC ID 3577820851, 7 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• United Health Services Hospitals, Inc Hospital, Binghamton, NY, CCN 330394

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine, Physician Assistant

State licenses

Practice roles

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.

• New Season Dermatology, PLLC

  dba Anew Dermatology

  • MOHS-Micrographic Surgery Physician
  • Johnson City, NY
  • NPI 1992215180
  Medicare reassignment Care Compare group
• The Dermatology Center of Raleigh

  • Dermatology Physician
  • Raleigh, NC
  • NPI 1295930865

  Single Specialty

  NPD (past)

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

• United Health Services Hospitals, Inc.

  • General Acute Care Hospital
  • Binghamton, NY
  • NPI 1518998699
  Care Compare affiliation

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

{
    "created_epoch": "1350000000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759968000000",
    "number": "1922350073",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "302 REYNOLDS RD STE A",
            "city": "JOHNSON CITY",
            "state": "NY",
            "postal_code": "137901308",
            "telephone_number": "607-444-5446",
            "fax_number": "607-444-5447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "302 REYNOLDS RD STE A",
            "city": "JOHNSON CITY",
            "state": "NY",
            "postal_code": "137901308",
            "telephone_number": "607-444-5446",
            "fax_number": "607-444-5447"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'NEIL",
        "first_name": "SHANE",
        "middle_name": "R",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-10-12",
        "last_updated": "2025-10-09",
        "certification_date": "2025-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "016116",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-08374",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Muhammad Atif Masood Noori
• Lauren Elizabeth Notchick, PA
• Kara Ann Nunn, M.S., CCC-SLP
• Irene Mukeli Nzasi, CRNA
• Paige Marie O'Neil, MS, RDN, LDN, CNSC
• Oakdale Mall Dental LLP
• Oakdale Psychology Associates
• Michal Obrzut, MD
• Peter Babatunde Ojo, M.D
• Sean Okeefe

• Physician Assistant in Johnson City, NY
• Providers in Johnson City, NY by specialty
• Physician Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2025; 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.