MARY M SHANNON (CRNP) – Family Nurse Practitioner, NPI 1104816073
Family Nurse Practitioner
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
11,473 NURSE PRACTITIONER in PA
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Provider Addresses for MARY M SHANNON (CRNP)
Adagio Medical Office, 3530, Peach Street, South Suburban Erie, Erie, Erie County, Pennsylvania, 16508, United States
SUITE LL1
ERIE, PA 165082768
Phone:
Type: Mailing
Armstrong County Memorial Hospital, 1, Nolte Drive, Kittanning, Armstrong County, Pennsylvania, 16201, United States
KITTANNING, PA 162017111
Phone: (724) 543-8536
Fax: (724) 543-8743
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 4 Open Payments records for all available years, with a total value of $112.
Total Amount is formed as General ($112) + Research ($0) + Ownership ($0) = $112.
Last reported payment date: 2024-10-01 • Largest payer in this snapshot: TACTILE SYSTEMS TECHNOLOGY INC ($38).
Total Amount
$112
General + Research + Ownership
Payments
4
Total payment records
General Amount
$112
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-10-01
Latest reported date
Top Companies
Largest payers in this snapshot
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: 2004-10-27
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20041027001019 | I | Nurse Practitioner | PA | TBD |
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.
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
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 99222 | Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes | 13 | 13 | $0 |
| 99204 | New patient office or other outpatient visit, 45-59 minutes | 12 | 12 | $0 |
Insurance plans in this area (ZIP 16508)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| NURSE PRACTITIONER | PA | 11042 | Removal of skin and tissue first 20 sq cm or less | 36 | 26 |
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