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DR. SHANLEY MARIE O'BRIEN MD
NPI 1104265933
Internal Medicine - Rheumatology in Traverse City, MI

Active since June 14, 2013PECOS Enrolled
4100 PARK FOREST DR STE 200, TRAVERSE CITY, MI 49684(231) 600-7466 Get Directions Write a Review

NPPES record last updated: November 10, 2022. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Nov 10, 2022, Jun 21, 2016 (2 updates tracked since 2016).

About Dr. Shanley Marie O'brien Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. SHANLEY MARIE O'BRIEN MD (NPI 1104265933) is an individual rheumatology provider in Traverse City, Michigan, licensed in Michigan (4301500409) and active in the NPI registry since June 2013. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1104265933
Entity TypeIndividualFemale
Primary Taxonomy207RR0500X
Provider Legal NameDR. SHANLEY MARIE O'BRIENCredential: MD
Location Address4100 PARK FOREST DR STE 200Traverse City, MI 49684-7306
Mailing Address4100 Park Forest Dr Ste 200Traverse City, MI 49684-7306 · (231) 600-7466 · Fax (913) 588-8182
Phone(231) 600-7466
Sole ProprietorYes
Enumeration DateJune 14, 2013
Last NPPES UpdateNovember 10, 20222 updates tracked since enumeration
NPPES CertifiedNovember 10, 2022
✔ NPI 1104265933 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyInternal Medicine · RheumatologyAllopathic & Osteopathic Physicians
Taxonomy Code207RR0500X
License✔ Licensed in MI · 4301500409
Definition
An internist who treats diseases of joints, muscle, bones and tendons. This specialist diagnoses and treats arthritis, back pain, muscle strains, common athletic injuries and collagen diseases.
Also ListedInternal MedicineTaxonomy 207R00000X · License 9408209 (KS)
4100 PARK FOREST DR STE 200, Traverse City, MI 49684
Open in Google Maps ↗

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Shanley Marie O'brien Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Shanley O'brien reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Novello Specialty Clinic PC
Same address
Multi-Specialty
4100 PARK FOREST DR STE 200
Traverse City, MI 49684
  • Reassigned Medicare billing, Michigan enrollment
  • 5 clinicians in this Medicare group
NPI 1629716964 (231) 600-7466

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 49684 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$126.15 typical visit price
range $54.34 – $166.68
Typical copayment $31.53 (range $13.58 – $41.67)
Most-billed visit code 99204
Established Patient
$96.44 typical visit price
range $17.09 – $135.40
Typical copayment $24.11 (range $4.27 – $33.85)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 5

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MICHAEL HARRIS MD
Urology
4100 PARK FOREST DR STE 200
TRAVERSE CITY, MI 49684
Grand Traverse County (231) 600-7466
MR. CORNELIUS ROBENS M.D.
Psychiatry & Neurology (Neurology)
4100 PARK FOREST DR STE 200
TRAVERSE CITY, MI 49684
Grand Traverse County (231) 600-7466
NOVELLO SPECIALTY CLINIC PC
Clinic/Center (Multi-Specialty)
4100 PARK FOREST DR STE 200
TRAVERSE CITY, MI 49684
Grand Traverse County (231) 600-7466
JENNA ROSE STODDARD FNP
Nurse Practitioner (Family)
4100 PARK FOREST DR STE 200
TRAVERSE CITY, MI 49684
Grand Traverse County (231) 600-7466
ALICIA HILL PA-C
Physician Assistant
4100 PARK FOREST DR STE 200
TRAVERSE CITY, MI 49684
Grand Traverse County (231) 600-7466

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Shanley O'brien's NPI number?

The NPI number for Shanley O'brien is 1104265933. It was assigned to this individual provider in the NPPES registry on June 14, 2013.

Where is Shanley O'brien located?

Shanley O'brien practices at 4100 Park Forest Dr Ste 200, Traverse City, MI 49684. The listed phone number is (231) 600-7466.

What is Shanley O'brien's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Rheumatology, with taxonomy code 207RR0500X.

Is Shanley O'brien enrolled in Medicare?

Yes. Shanley O'brien is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Shanley O'brien's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Shanley O'brien reassigns Medicare benefits to Novello Specialty Clinic PC (Traverse City, MI). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Shanley O'brien's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Shanley O'brien was last updated on November 10, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.