Kelly Shannon, MSN, RN, FNP-BC, CEN - Medicare Nurse Practitioner in Mountain House, CA

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Kelly Shannon, MSN, RN, FNP-BC, CEN is a medicare enrolled "Nurse Practitioner - Family" in Mountain House, California. She graduated from nursing school in 2016 and has 8 years of diverse experience with area of expertise as Nurse Practitioner. She is a member of the group practice Pleasanton Emergency Medical Group and her current practice location is 669 W Tramonto Dr, Mountain House, California. You can reach out to her office (for appointments etc.) via phone at (210) 878-7220.

Kelly Shannon is licensed to practice in California (license number 95004710) and she also participates in the medicare program. She accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1265886071.

Contact Information

Kelly Shannon, MSN, RN, FNP-BC, CEN
669 W Tramonto Dr,
Mountain House, CA 95391-1243
(210) 878-7220
Not Available

Map and Direction




Provider's Profile

Full NameKelly Shannon
GenderFemale
SpecialityNurse Practitioner
Experience8 Years
Location669 W Tramonto Dr, Mountain House, California
Accepts Medicare AssignmentsYes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.
  Medical Education and Training:
  • Kelly Shannon graduated from nursing school in 2016
  NPI Data:
  • NPI Number: 1265886071
  • Provider Enumeration Date: 04/18/2016
  • Last Update Date: 09/07/2016
  Medicare PECOS Information:
  • PECOS PAC ID: 4981986999
  • Enrollment ID: I20170622000771

Medical Identifiers

Medical identifiers for Kelly Shannon such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1265886071NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
163WE0003XRegistered Nurse - Emergency 724598 (California)Secondary
363LF0000XNurse Practitioner - Family 95004710 (California)Primary

Medical Facilities Affiliation

Facility NameLocationFacility Type
Stanford Health Care - ValleycarePleasanton, CAHospital

Group Practice Association

Group Practice NameGroup PECOS PAC IDNo. of Members
Pleasanton Emergency Medical Group014311892737

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Kelly Shannon allows following entities to bill medicare on her behalf.
Entity NamePleasanton Emergency Medical Group
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1285625509
PECOS PAC ID: 0143118927
Enrollment ID: O20040304001270
Entity NameLodi Memorial Hospital Association Inc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1861649352
PECOS PAC ID: 7618880717
Enrollment ID: O20050517000577

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Kelly Shannon is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Kelly Shannon, MSN, RN, FNP-BC, CEN
669 W Tramonto Dr,
Mountain House, CA 95391-1243

Ph: (210) 878-7220		Kelly Shannon, MSN, RN, FNP-BC, CEN
669 W Tramonto Dr,
Mountain House, CA 95391-1243

Ph: (210) 878-7220

Reviews and Comments


Nurse Practitioner Nurses in Mountain House, CA

Miss Disan Flores Yap, APRN, BC
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Phone: 510-364-7374    Fax: 209-839-0119
Parbjeet Kaur,
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Practice Location: 130 W Invitar Ln, Mountain House, CA 95391
Phone: 661-717-8629    
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Practice Location: 855 N Melita Ct, Mountain House, CA 95391
Phone: 510-415-7256    

Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.