Shannon Gail Stark, MA CCC/SLP, NP-C is a medicare enrolled "Nurse Practitioner - Family" provider in Sidney, New York. She graduated from medical school in 2018 and has 6 years of diverse experience with area of expertise as Nurse Practitioner. She is a member of the group practice Bassett Healthcare and her current practice location is
39 Pearl St W, Sidney, New York. You can reach out to her office (for appointments etc.) via phone at
(607) 561-2021.
Shannon Gail Stark is licensed to practice in New York (license number 343815) 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 1003129438.
Healthcare Provider's Profile
| Full Name | Shannon Gail Stark |
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| Gender | Female |
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| Speciality | Nurse Practitioner |
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| Experience | 6 Years |
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| Location | 39 Pearl St W, Sidney, New York |
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| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Shannon Gail Stark graduated from medical school in 2018
NPI Data:
- NPI Number: 1003129438
- Provider Enumeration Date: 07/14/2010
- Last Update Date: 02/04/2019
Medicare PECOS Information:
- PECOS PAC ID: 3375885163
- Enrollment ID: I20190426000539
Medical Identifiers
Medical identifiers for Shannon Gail Stark such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1003129438 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 235Z00000X | Speech-language Pathologist | 0106541 (New York) | Secondary |
| 363LF0000X | Nurse Practitioner - Family | 343815 (New York) | Primary |
Medical Facilities Affiliation
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
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| Bassett Healthcare | 3779488325 | 641 |
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 Gail Stark allows following entities to bill medicare on her behalf.
| Provider Name | Mary Imogene Bassett Hospital |
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| Provider Type | Part B Supplier - Clinic/group Practice |
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| Provider Identifiers | NPI Number: 1083664221
PECOS PAC ID: 3779488325
Enrollment ID: O20031205000553 |
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| Provider Name | Mary Imogene Bassett Hospital |
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| Provider Type | Part B Supplier - Clinic/group Practice |
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| Provider Identifiers | NPI Number: 1083664221
PECOS PAC ID: 3779488325
Enrollment ID: O20040120000834 |
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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 Gail Stark 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 |
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Shannon Gail Stark, MA CCC/SLP, NP-C
205 Crocker Hill Rd,
Binghamton, NY 13904-2513
Ph: (212) 927-9706 | Shannon Gail Stark, MA CCC/SLP, NP-C
39 Pearl St W,
Sidney, NY 13838
Ph: (607) 561-2021 |
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