Shannon Kelly Quackenbush, CRNA in Buffalo, NY - Medicare Certified Registered Nurse Anesthetist (crna)

Shannon Kelly Quackenbush, CRNA is a medicare enrolled "Nurse Anesthetist, Certified Registered" in Buffalo, New York. She graduated from nursing school in 2011 and has 14 years of diverse experience with area of expertise as Certified Registered Nurse Anesthetist (crna). She is a member of the group practice Great Lakes Anesthesiology Pc, Great Lakes Anesthesiology Pc, Premier Anesthesia Of New York, P.c. and her current practice location is 1001 Main St Ste K-3502, Buffalo, New York. You can reach out to her office (for appointments etc.) via phone at (716) 323-6658.

Shannon Kelly Quackenbush is licensed to practice in New York (license number 748921-1) 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 1730709486.

Contact Information

	Shannon Kelly Quackenbush, CRNA
	1001 Main St Ste K-3502, Buffalo, NY 14203-1009
	(716) 323-6658
	Not Available

Map and Direction

Provider's Profile

Full Name	Shannon Kelly Quackenbush
Gender	Female
Speciality	Certified Registered Nurse Anesthetist (crna)
Experience	14 Years
Location	1001 Main St Ste K-3502, Buffalo, New York
Accepts Medicare Assignments	Yes. 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 Kelly Quackenbush graduated from nursing school in 2011

NPI Data:

NPI Number: 1730709486
Provider Enumeration Date: 04/23/2020
Last Update Date: 08/01/2025

Medicare PECOS Information:

PECOS PAC ID: 7416379797
Enrollment ID: I20200615000195

Medical Identifiers

Medical identifiers for Shannon Kelly Quackenbush such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1730709486	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
163W00000X	Registered Nurse	RN178240 (Arizona)	Secondary
367500000X	Nurse Anesthetist, Certified Registered	RN629994 (Pennsylvania)	Secondary
367500000X	Nurse Anesthetist, Certified Registered	748921-1 (New York)	Primary

Medical Facilities Affiliation

Facility Name	Location	Facility Type
Warren General Hospital	Warren, PA	Hospital
Upmc Chautauqua At Wca	Jamestown, NY	Hospital

Group Practice Association

Group Practice Name	Group PECOS PAC ID	No. of Members
Great Lakes Anesthesiology Pc	7113997529	74
Great Lakes Anesthesiology Pc	7113997529	74
Premier Anesthesia Of New York, P.c.	7719041102	48

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. Shannon Kelly Quackenbush allows following entities to bill medicare on her behalf.

Entity Name	Great Lakes Anesthesiology Pc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1306852181 PECOS PAC ID: 7113997529 Enrollment ID: O20171129002800

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 Kelly Quackenbush 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 Address	Practice Location Address
Shannon Kelly Quackenbush, CRNA 1001 Main St # K3502, Buffalo, NY 14203-1009 Ph: (716) 323-6570	Shannon Kelly Quackenbush, CRNA 1001 Main St Ste K-3502, Buffalo, NY 14203-1009 Ph: (716) 323-6658

Reviews and Comments

Nurse Anesthetist, Certified Registered Nurses in Buffalo, NY

Miriam Sue Ernst, CRNA Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare Practice Location: 219 Bryant St, Cgf Anesthesia Associates Pc, Buffalo, NY 14222 Phone: 716-878-7444 Fax: 716-878-7316
Ms. Alyssa Harper Miller, Nurse Anesthetist - CR Medicare: Medicare Enrolled Practice Location: 2157 Main St, Buffalo, NY 14214 Phone: 716-836-7510
Brian Evans, Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 818 Ellicott St, Buffalo, NY 14203 Phone: 716-323-6570 Fax: 716-323-6658
Mrs. Carol Devincentis, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 2157 Main St, Buffalo, NY 14214 Phone: 716-836-7510
Mrs. Natalie J Kney, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 2157 Main St, Buffalo, NY 14214 Phone: 716-836-7510 Fax: 716-832-3540
Raymond Joseph Masters, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 462 Grider St, Buffalo, NY 14215 Phone: 716-898-3436
Dr. Jeffrey Tinen, Nurse Anesthetist - CR Medicare: Medicare Enrolled Practice Location: 3495 Bailey Ave, Buffalo, NY 14215 Phone: 716-834-9200

Shannon Kelly Quackenbush, CRNA - Medicare Certified Registered Nurse Anesthetist (crna) in Buffalo, NY