SHANNON MCKERNAN SUTHERLAND (MD) – Obstetrics & Gynecology Physician, NPI 1508277575

SHANNON MCKERNAN SUTHERLAND (MD) is a healthcare provider. based in Glastonbury, Connecticut. specializing in OBSTETRICS/GYNECOLOGY. They hold the professional credentials MD. They hold a License No. 61130 (CT). The NPI Number for SHANNON MCKERNAN SUTHERLAND (MD) is 1508277575

Main info

Female
12 Years Of Experience
Accepts Medicare Assignment
Name
SHANNON MCKERNAN SUTHERLAND (MD)
NPI
1508277575
Phone
(860) 547-0306
Address
330 WESTERN BLVD STE 102
Enumeration Date
13 May 2014
Last Update Date
7 June 2018

Doctor Profile

Medical School Name
NEW YORK MEDICAL COLLEGE
Secondary Phone
8605470306
Graduation Year
2014 (12 years ago)
PAC ID
4587984612
Group Practice PAC ID
3274430665
Professional Enrollment ID
I20180717001160
Address ID
CT061062553HA100XXAVEX301
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience38
Completeness75
Years active:12State licenses:1Digital endpointsOther names

827 OBSTETRICS/GYNECOLOGY in CT

Provider Addresses for SHANNON MCKERNAN SUTHERLAND (MD)

  • 330 WESTERN BLVD STE 102

    GLASTONBURY, CT 060334383

    Phone: (860) 547-0306

    Fax: (860) 525-9782

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 2 Open Payments records for all available years, with a total value of $51.

Total Amount is formed as General ($51) + Research ($0) + Ownership ($0) = $51.

Last reported payment date: 2024-04-03 • Largest payer in this snapshot: CooperSurgical, Inc. ($33).

Total Amount

$51

General + Research + Ownership

Payments

2

Total payment records

General Amount

$51

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-04-03

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2018-07-17

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20180717001160IObstetrics/GynecologyCTTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
96127Assessment of emotional or behavioral problems4343$0
81002Urinalysis, manual test3939$0
G0101Cervical or vaginal cancer screening; pelvic and clinical breast examination3535$0
99213Established patient office or other outpatient visit, 20-29 minutes2620$0
77063Screening 3d breast mammography1111$0
View full utilization report →

Insurance plans in this area (ZIP 06033)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 3274430665View full group profile
NameSpecialtyState
O B S T E T R I C S/ G Y N E C O L O G YCT
O B S T E T R I C S/ G Y N E C O L O G YWI
-CT
O B S T E T R I C S/ G Y N E C O L O G YCT
Certified Nurse Midwife (Cnm)CT
O B S T E T R I C S/ G Y N E C O L O G YCT
Certified Nurse Midwife (Cnm)MD
-CT
-CT
O B S T E T R I C S/ G Y N E C O L O G YCT

Reviews

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Frequently asked questions

What NPI should I save for SHANNON MCKERNAN SUTHERLAND (MD)?
Save NPI 1508277575 if you need a stable reference for SHANNON MCKERNAN SUTHERLAND (MD).
Is SHANNON MCKERNAN SUTHERLAND (MD)'s enrollment marked active?
An active flag here means the NPI record is not in a deactivated state.
Can you summarize SHANNON MCKERNAN SUTHERLAND (MD)'s specialty in plain language?
Clinically, the directory lists SHANNON MCKERNAN SUTHERLAND (MD) with Obstetrics & Gynecology Physician. Clinical services aligned with this taxonomy classification.
Where is SHANNON MCKERNAN SUTHERLAND (MD)'s primary listing?
We display Glastonbury, Connecticut because that is what the record indicates for SHANNON MCKERNAN SUTHERLAND (MD).
Does Medicare enrollment show here?
Medicare enrollment screens are separate from the basic NPI extract shown here.

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