SHANNON PATRICK BUCK (D.O.) – Dermatology Physician, NPI 1578895744

SHANNON PATRICK BUCK (D.O.) is a healthcare provider. based in Austin, Texas. specializing in DERMATOLOGY, MICROGRAPHIC DERMATOLOGIC SURGERY (MDS). They hold the professional credentials D.O.. They hold a License No. S0144 (TX). The NPI Number for SHANNON PATRICK BUCK (D.O.) is 1578895744

Main info

Male
Sole Proprietor
16 Years Of Experience
Accepts Medicare Assignment
Name
SHANNON PATRICK BUCK (D.O.)
NPI
1578895744
Phone
(512) 628-0465
Address
7300 RANCH ROAD 2222, BLDG 1, STE 200
Enumeration Date
12 February 2010
Last Update Date
11 October 2024

Doctor Profile

Medical School Name
KAISER PERMANENTE SCHOOL OF MEDICINE
Secondary Phone
7262133494
Graduation Year
2010 (16 years ago)
PAC ID
4385874825
Group Practice PAC ID
3971827791
Professional Enrollment ID
I20190410001030
Address ID
TX782311896SA11503HWYX407
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience61
Completeness75
Years active:16State licenses:1Digital endpointsOther names

1,287 DERMATOLOGY in TX

Provider Addresses for SHANNON PATRICK BUCK (D.O.)

  • 7300 RANCH ROAD 2222, BLDG 1, STE 200

    AUSTIN, TX 78730

    Phone: (512) 628-0465

    Type: Mailing

  • 1100 WILFORD HALL LOOP BLDG 4554

    JBSA LACKLAND, TX 78236

    Phone: (210) 292-8200

    Fax: (210) 292-3781

    Type: Location

  • 7979 Wurzbach Rd

    San Antonio, TX 782294427

    Phone: (210) 450-9000

    Type: Location

  • 11503 NW Military Hwy Ste 321

    San Antonio, TX 78231

    Phone: (726) 213-3494

    Type: Location

  • 2200 Bergquist Dr

    Suite 1

    Jbsa Lackland, TX 782369907

    Phone: (210) 292-5350

    Fax: (210) 292-3781

    Type: Location

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: 2019-04-10

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
I20190410001030IDermatologyTXTBD

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 78730)

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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: 3971827791View full group profile
NameSpecialtyState
Physician AssistantTX
D E R M A T O L O G YTX
Physician AssistantTX
D E R M A T O L O G YTX
Interventional Radiology, Diagnostic RadiologyTX
D E R M A T O L O G YTX
D E R M A T O L O G YTX
D E R M A T O L O G YTX
D E R M A T O L O G YTX
Physician AssistantAZ

Reviews

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Frequently asked questions

What is the registry number for SHANNON PATRICK BUCK (D.O.)?
The registry entry for SHANNON PATRICK BUCK (D.O.) shows NPI 1578895744.
Quick check: is SHANNON PATRICK BUCK (D.O.) active?
Public NPPES data shows SHANNON PATRICK BUCK (D.O.) with an active NPI status right now.
What type of care does SHANNON PATRICK BUCK (D.O.) provide?
SHANNON PATRICK BUCK (D.O.)'s profile centers on Dermatology Physician. Clinical services aligned with this taxonomy classification.
What geographic area is tied to SHANNON PATRICK BUCK (D.O.)?
SHANNON PATRICK BUCK (D.O.) is associated with Austin, Texas in the same public data insurers reference.
Can I export SHANNON PATRICK BUCK (D.O.)'s record?
You can download the official NPPES record; we summarize key fields for readability.

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