Individual provider Active NPI

Shannon McFall, PA-C

  • Physician Assistant
  • Orchard Park, NY
National Provider Identifier
1992207765
Registry record updated Mar 7, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
021902 Issued in NY
Practice address
3065 Southwestern Blvd Ste 102
Orchard Park, NY 14127-1239
Phone
(716) 362-3909
Fax
(716) 608-6022
NPI assigned
Mar 7, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 021902 NY Primary

Addresses

Primary practice location

3065 Southwestern Blvd Ste 102
Orchard Park, NY 14127-1239

Mailing address

3065 Southwestern Blvd Ste 102
Orchard Park, NY 14127-1239
Phone (716) 362-3909

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20180425002438 NY Practitioner - Physician Assistant 2163786286 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Amy J Burke MD PCGroup PAC ID 0143465419, 4 clinicians

Practice addresses (Care Compare)

3775 Southwestern Blvd
Suite a
Orchard Park, NY 14127-1762
Phone 71636239094

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Interoperability endpoints

  • Direct secure messaging: shannon.mcfall@sunrisewny.medentdirect.com

Organizations & group practices 1

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 3

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": "1520380800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1520380800000",
    "number": "1992207765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3065 SOUTHWESTERN BLVD STE 102",
            "city": "ORCHARD PARK",
            "state": "NY",
            "postal_code": "141271239",
            "telephone_number": "716-362-3909",
            "fax_number": "716-608-6022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3065 SOUTHWESTERN BLVD STE 102",
            "city": "ORCHARD PARK",
            "state": "NY",
            "postal_code": "141271239",
            "telephone_number": "716-362-3909",
            "fax_number": "716-608-6022"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCFALL",
        "first_name": "SHANNON",
        "name_prefix": "Miss",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-03-07",
        "last_updated": "2018-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "021902",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orchard Park, NY

Sources for this page

Verify at the official NPI Registry.