Shannon Blake, PA - Medicare Physician Assistant in West Hartford, CT

Shannon Blake, PA is a medicare enrolled "Physician Assistant" in West Hartford, Connecticut. She graduated from nursing school in 2006 and has 18 years of diverse experience with area of expertise as Physician Assistant. She is a member of the group practice Lifesource Of North Carolina and her current practice location is 631 Quaker Ln S, West Hartford, Connecticut. You can reach out to her office (for appointments etc.) via phone at (860) 233-5133.

Shannon Blake is licensed to practice in Connecticut (license number 001550) 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 1578509238.

Contact Information

Shannon Blake, PA
631 Quaker Ln S,
West Hartford, CT 06110-1026
(860) 233-5133
(860) 232-6527

Map and Direction




Provider's Profile

Full NameShannon Blake
GenderFemale
SpecialityPhysician Assistant
Experience18 Years
Location631 Quaker Ln S, West Hartford, Connecticut
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:
  • Shannon Blake graduated from nursing school in 2006
  NPI Data:
  • NPI Number: 1578509238
  • Provider Enumeration Date: 06/21/2006
  • Last Update Date: 07/28/2011
  Medicare PECOS Information:
  • PECOS PAC ID: 6406943448
  • Enrollment ID: I20190624003539

Medical Identifiers

Medical identifiers for Shannon Blake such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1578509238NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
363A00000XPhysician Assistant 001550 (Connecticut)Primary

Group Practice Association

Group Practice NameGroup PECOS PAC IDNo. of Members
Lifesource Of North Carolina7416132428154

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. Shannon Blake 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
Shannon Blake, PA
229 Henry St,
Manchester, CT 06042-3243

Ph: (860) 371-5335
Shannon Blake, PA
631 Quaker Ln S,
West Hartford, CT 06110-1026

Ph: (860) 233-5133

Reviews and Comments


Physician Assistant Nurses in West Hartford, CT

Emma Woodward, PA
Physician Assistant
Medicare: Accepting Medicare Assignments
Practice Location: 65 Memorial Rd Ste 508, West Hartford, CT 06107
Phone: 860-696-2925    
Erica Falger,
Physician Assistant
Medicare: Medicare Enrolled
Practice Location: 65 Memorial Rd Ste 435, West Hartford, CT 06107
Phone: 860-696-2840    Fax: 860-696-2845
Ms. Marybeth Aucoin Moore, PA-C, MPH
Physician Assistant
Medicare: Accepting Medicare Assignments
Practice Location: 631 Quaker Ln S, West Hartford, CT 06110
Phone: 860-233-5133    Fax: 860-233-5212
Justin Hong, PA-C
Physician Assistant
Medicare: Not Enrolled in Medicare
Practice Location: 836 Farmington Ave Ste 207, West Hartford, CT 06119
Phone: 860-232-9911    
Vanessa C Pacholski, P.A.-C.
Physician Assistant
Medicare: Not Enrolled in Medicare
Practice Location: 970 Farmington Ave, Suite 201, West Hartford, CT 06107
Phone: 860-561-4300    Fax: 860-561-1635
Mrs. Stephanie Gort, PA-C
Physician Assistant
Medicare: Accepting Medicare Assignments
Practice Location: 60 Barksdale Rd, West Hartford, CT 06117
Phone: 860-985-4188    
Audrey Kinnear Oweimrin, PA-C
Physician Assistant
Medicare: Medicare Enrolled
Practice Location: 342 N Main St Ste 350, West Hartford, CT 06117
Phone: 860-296-4022    

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.