DR. SHANNON O'ROURKE (AUD) – Audiologist, NPI 1902550874

DR. SHANNON O'ROURKE (AUD) is a healthcare provider. based in West hartford, Connecticut. specializing in QUALIFIED AUDIOLOGIST. They hold the professional credentials AUD. They hold a License No. 4866 (MA). The NPI Number for DR. SHANNON O'ROURKE (AUD) is 1902550874

Main info

Female
5 Years Of Experience
Accepts Medicare Assignment
Name
DR. SHANNON O'ROURKE (AUD)
NPI
1902550874
Phone
(860) 561-2345
Address
28 N Main St Ste 101
Enumeration Date
9 February 2022
Last Update Date
11 July 2024

Doctor Profile

Medical School Name
UNIVERSITY OF CONNECTICUT SCHOOL OF MEDICINE
Secondary Phone
8605293443
Graduation Year
2021 (5 years ago)
PAC ID
0042744138
Group Practice PAC ID
6901943018
Professional Enrollment ID
I20241112003176
Address ID
CT061094201WE919XXHWYX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience32
Completeness75
Years active:4State licenses:1Digital endpointsOther names

133 QUALIFIED AUDIOLOGIST in CT

Provider Addresses for DR. SHANNON O'ROURKE (AUD)

  • 28 N Main St Ste 101

    West Hartford, CT 061071987

    Phone: (860) 561-2345

    Fax: (860) 561-2666

    Type: Location

  • 60 NORTH ST

    HYANNIS, MA 026013808

    Phone: (508) 775-0959

    Type: Mailing

  • 919 SILAS DEANE HWY

    WETHERSFIELD, CT 061094201

    Phone: (860) 529-3443

    Fax: (860) 513-1277

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

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: 2024-11-12

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
I20241112003176IQualified AudiologistCTTBD

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.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 06107)

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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: 6901943018View full group profile
NameSpecialtyState
Qualified AudiologistCT
-CT
Qualified AudiologistCT

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Frequently asked questions

What is the 10-digit NPI for DR. SHANNON O'ROURKE (AUD)?
DR. SHANNON O'ROURKE (AUD) — NPI 1902550874 — is the standard way to identify this listing.
Does CMS list DR. SHANNON O'ROURKE (AUD) as active?
Yes — DR. SHANNON O'ROURKE (AUD) is active in the NPI listing used on this page.
What taxonomy line describes DR. SHANNON O'ROURKE (AUD)?
For research purposes, treat DR. SHANNON O'ROURKE (AUD) as Audiologist in this dataset. Clinical services aligned with this taxonomy classification.
What address line appears for DR. SHANNON O'ROURKE (AUD)?
DR. SHANNON O'ROURKE (AUD)'s geographic hint is West Hartford, Connecticut in our summary view.
How many locations tie to this NPI?
5 practice locations appear in the available data.

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