BROOKE SHANNON (PA) – Physician Assistant, NPI 1740756261
Physician Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
3,678 PHYSICIAN ASSISTANT in WI
Provider Addresses for BROOKE SHANNON (PA)
507 S Monroe St
Lancaster, WI 538132099
Phone: (608) 723-2143
Type: Location
4201, Buffalo Road, Coldwater, Chili, Monroe, New York, 14514, United States
NORTH CHILI, NY 145141256
Phone: (585) 594-5995
Fax: (585) 594-5425
Type: Mailing
1450 EASTSIDE RD
PLATTEVILLE, WI 538189800
Phone: (608) 342-5060
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 71 Open Payments records for all available years, with a total value of $1,229.
Total Amount is formed as General ($1,229) + Research ($0) + Ownership ($0) = $1,229.
Last reported payment date: 2024-12-10 • Largest payer in this snapshot: ABBVIE INC. ($488).
Total Amount
$1,229
General + Research + Ownership
Payments
71
Total payment records
General Amount
$1,229
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-10
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| ABBVIE INC. | $488 |
| PFIZER INC. | $66 |
| Amgen Inc. | $65 |
| Novartis Pharmaceuticals Corporation | $62 |
| Boehringer Ingelheim Pharmaceuticals, Inc. | $54 |
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: 2022-01-05
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 |
|---|---|---|---|---|
| I20220105000418 | I | Physician Assistant | WI | 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.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 53813)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Certified Registered Nurse Anesthetist (Crna) | WI | |
| Family Practice | WI | |
| Physical Therapist In Private Practice | IA | |
| Occupational Therapist In Private Practice | WI | |
| Physical Therapist In Private Practice | IA | |
| Physician Assistant | WI | |
| Cardiovascular Disease (Cardiology) | TX | |
| Family Practice | FL | |
| Pediatric Medicine | WI | |
| Qualified Speech Language Pathologist | WI |
Reviews
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