Tracy Shannon

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

345858 Issued in NY

Practice address

75 Montgomery St FL 603
Jersey City, NJ 07302-3726

Phone

(201) 433-1955

NPI assigned

Dec 20, 2020

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

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: tshannon629471@nyumc.direct-ci.com
• Direct secure messaging: trs9024@direct.nyp.org

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.

• New York University

  • Otolaryngology Physician
  • New York, NY
  • NPI 1851456701
  Medicare reassignment NPD
• New York University

  • Physical Medicine & Rehabilitation Physician
  • Boynton Beach, FL
  • NPI 1104787613
  NPD
• New York University

  • Anesthesiology Physician
  • Boynton Beach, FL
  • NPI 1952392946
  NPD
• Harborside Sport & Spine LLC

  • Rehabilitation Practitioner
  • Jersey City, NJ
  • NPI 1407079833
  NPD (past)

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

{
    "created_epoch": "1608422400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625184000000",
    "number": "1992391320",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "75 MONTGOMERY ST FL 603",
            "city": "JERSEY CITY",
            "state": "NJ",
            "postal_code": "073023726",
            "telephone_number": "201-433-1955"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75 MONTGOMERY ST FL 603",
            "city": "JERSEY CITY",
            "state": "NJ",
            "postal_code": "073023726",
            "telephone_number": "201-433-1955"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHANNON",
        "first_name": "TRACY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-12-20",
        "last_updated": "2021-07-02",
        "certification_date": "2021-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "345858",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mahammad Rafi Shaik, PT
• Alan Marc Shaiman, MD
• Ibn Sharif Shakoor, LPC
• Eriny Mourzak Shalaby
• Shambhavi, LLC
• Jamie Shapiro
• Saad Sharif, M.D
• Anita Sharma, OTR/L
• Misha Sharma, APN
• Parshotam Kumar Sharma, OPTICIANS

• Family Nurse Practitioner in Jersey City, NJ
• Providers in Jersey City, NJ by specialty
• Family Nurse Practitioner in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.