MRS. SHANNON NICOLE FORLIVIO (PA-C) – Physician Assistant, NPI 1316660558

MRS. SHANNON NICOLE FORLIVIO (PA-C) is a healthcare provider. based in Pembroke, Massachusetts. specializing in PHYSICIAN ASSISTANT. They hold the professional credentials PA-C. They hold a License No. PS9068 (MA). The NPI Number for MRS. SHANNON NICOLE FORLIVIO (PA-C) is 1316660558

Main info

Female
4 Years Of Experience
Accepts Medicare Assignment
Name
MRS. SHANNON NICOLE FORLIVIO (PA-C)
NPI
1316660558
Phone
Not provided
Address
35 COPPERWOOD RD
Enumeration Date
22 September 2022
Last Update Date
15 September 2023

Doctor Profile

Medical School Name
BOSTON UNIVERSITY SCHOOL OF MEDICINE
Secondary Phone
6176388609
Graduation Year
2022 (4 years ago)
PAC ID
6901279041
Group Practice PAC ID
9830183763
Professional Enrollment ID
I20230310000778
Address ID
MA021182908BO1XXXXPLXX503
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience30
Completeness75
Years active:3State licenses:1Digital endpointsOther names

5,091 PHYSICIAN ASSISTANT in MA

Provider Addresses for MRS. SHANNON NICOLE FORLIVIO (PA-C)

  • 35 COPPERWOOD RD

    PEMBROKE, MA 023592488

    Phone:

    Type: Mailing

  • 960 MASSACHUSETTS AVENUE

    FL 2

    BOSTON, MA 02118

    Phone:

    Type: Mailing

  • 1 BOSTON MEDICAL CTR PL # C500

    BOSTON, MA 021182908

    Phone: (617) 638-8609

    Fax: (617) 638-8607

    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 $100.

Total Amount is formed as General ($100) + Research ($0) + Ownership ($0) = $100.

Last reported payment date: 2023-10-23 • Largest payer in this snapshot: Intuitive Surgical, Inc. ($100).

Total Amount

$100

General + Research + Ownership

Payments

1

Total payment records

General Amount

$100

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2023-10-23

Latest reported date

Top Companies

Largest payers in this snapshot

CompanyAmount
Intuitive Surgical, Inc.$100
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: 2023-03-10

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
I20230310000778IPhysician AssistantMATBD

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 02359)

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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: 9830183763View full group profile
NameSpecialtyState
Physician AssistantMA
Thoracic Surgery, Cardiac SurgeryMA
Thoracic Surgery, General SurgeryNY
Nurse PractitionerMA
Plastic And Reconstructive SurgeryPA
General SurgeryMA
General Surgery, Colorectal Surgery (Proctology)MA
Surgical Oncology, General SurgeryMA
Plastic And Reconstructive SurgeryMA
Vascular Surgery, General SurgeryMA

Reviews

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Frequently asked questions

How do payers reference MRS. SHANNON NICOLE FORLIVIO (PA-C)?
For MRS. SHANNON NICOLE FORLIVIO (PA-C), use NPI 1316660558 as the unique 10-digit identifier.
Is MRS. SHANNON NICOLE FORLIVIO (PA-C) still an active registrant?
MRS. SHANNON NICOLE FORLIVIO (PA-C) carries an active NPI according to the public dataset.
What kind of doctor is MRS. SHANNON NICOLE FORLIVIO (PA-C)?
MRS. SHANNON NICOLE FORLIVIO (PA-C) is associated with Physician Assistant in the directory — Clinical services aligned with this taxonomy classification.
Where in Massachusetts is MRS. SHANNON NICOLE FORLIVIO (PA-C) registered?
Use Pembroke, Massachusetts as the headline location for MRS. SHANNON NICOLE FORLIVIO (PA-C) here.
Does MRS. SHANNON NICOLE FORLIVIO (PA-C) accept insurance?
Insurance participation is not part of the core NPI extract — call the plan or office to confirm.

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