DR. MICHAEL SHANE HENNESY (MD) – Obstetrics & Gynecology Physician, NPI 1932194016

DR. MICHAEL SHANE HENNESY (MD) is a healthcare provider. based in Urbana, Illinois. specializing in OBSTETRICS/GYNECOLOGY. They hold the professional credentials MD. They hold a License No. 40865 (CO). The NPI Number for DR. MICHAEL SHANE HENNESY (MD) is 1932194016

Main info

Male
28 Years Of Experience
Accepts Medicare Assignment
Name
DR. MICHAEL SHANE HENNESY (MD)
NPI
1932194016
Phone
(217) 326-8630
Address
PO BOX 6002
Enumeration Date
15 September 2005
Last Update Date
20 April 2026

Doctor Profile

Medical School Name
UNIVERSITY OF COLORADO SCHOOL OF MEDICINE, DENVER
Secondary Phone
8887122753
Graduation Year
1998 (28 years ago)
PAC ID
7113043332
Group Practice PAC ID
3577515774
Professional Enrollment ID
I20130118000172
Address ID
IL618012501UR611XXSTXX400

Contacts

SOAP Endpoint
https://careepiceast.kp.org:14430/Interconnect-prodcom/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience64
Completeness95
Years active:20State licenses:1Other names

1,923 OBSTETRICS/GYNECOLOGY in IL

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Provider Addresses for DR. MICHAEL SHANE HENNESY (MD)

  • Urbana Post Office, 3100, Tatman Court, Urbana, Champaign County, Illinois, 61802, United States

    URBANA, IL 618036002

    Phone: (217) 326-8630

    Fax: (303) 426-4154

    Type: Mailing

  • 602, West University Avenue, Urbana, Champaign County, Illinois, 61801, United States

    URBANA, IL 618012530

    Phone: (217) 383-3140

    Fax: (217) 383-4966

    Type: Location

  • 10350 E DAKOTA AVE

    DENVER, CO 802471314

    Phone:

    Type: Mailing

  • 10240 PARK MEADOWS DR

    LONE TREE, CO 801245425

    Phone: (303) 338-4545

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 1 Open Payments records for all available years, with a total value of $18.

Total Amount is formed as General ($18) + Research ($0) + Ownership ($0) = $18.

Last reported payment date: 2024-11-06 • Largest payer in this snapshot: Organon LLC ($18).

Total Amount

$18

General + Research + Ownership

Payments

1

Total payment records

General Amount

$18

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-11-06

Latest reported date

Top Companies

Largest payers in this snapshot

CompanyAmount
Organon LLC$18
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: 2013-01-18

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
I20130118000172IObstetrics/GynecologyILTBD

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 61803)

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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: 3577515774View full group profile
NameSpecialtyState
G A S T R O E N T E R O L O G YIL
Nurse PractitionerIL
Clinical PsychologistIL
-FL
Nurse PractitionerIL
Gastroenterology, Internal MedicineWI
P O D I A T R YIL
Hospitalist, Family PracticeTX
Diagnostic RadiologyNY
-IL

Reviews

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Frequently asked questions

Can I verify DR. MICHAEL SHANE HENNESY (MD) with an NPI only?
You can start verification with NPI 1932194016 for DR. MICHAEL SHANE HENNESY (MD), then check state licensing separately.
Can I rely on DR. MICHAEL SHANE HENNESY (MD) being an active provider?
As of the registry snapshot, DR. MICHAEL SHANE HENNESY (MD) is marked active.
What is DR. MICHAEL SHANE HENNESY (MD)'s specialty?
The listing groups DR. MICHAEL SHANE HENNESY (MD) with Obstetrics & Gynecology Physician. Clinical services aligned with this taxonomy classification.
Does DR. MICHAEL SHANE HENNESY (MD) list a practice location?
Patients near Urbana, Illinois may find DR. MICHAEL SHANE HENNESY (MD) in results; validate coverage separately.
Is specialty guaranteed by NPI alone?
Taxonomy selections describe intent; scope of practice still follows state law.

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