1. Home
  2. Directory
  3. New York
  4. Albany
  5. Nurse Practitioner
  6. NPI Profile

SHANNON CHURCH
NPI 1104364686
Nurse Practitioner - Family in Albany, NY

Active since February 06, 2017PECOS Enrolled
5 PALISADES DRIVE SUITE 200, ST. PETER'S INTERNAL MEDICINE, ALBANY, NY 12205(518) 438-0019(518) 438-0299 Get Directions Write a Review

NPPES record last updated: May 12, 2021. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: May 12, 2021, Feb 6, 2017 (2 updates tracked since 2017).

About Shannon Church NPPES

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

SHANNON CHURCH (NPI 1104364686) is an individual family provider in Albany, New York, licensed in New York (F341370-1) and active in the NPI registry since February 2017. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1104364686
Entity TypeIndividualFemale
Primary Taxonomy363LF0000X
Provider Legal NameSHANNON CHURCH
Location Address5 PALISADES DRIVE SUITE 200, ST. PETER'S INTERNAL MEDICINEAlbany, NY 12205-6433
Mailing AddressPo Box 14890, St. Peter's Health Partners Payer CredentialingAlbany, NY 12212-4890 · (518) 525-5634
Phone(518) 438-0019
Fax(518) 438-0299
Sole ProprietorNo
Enumeration DateFebruary 6, 2017
Last NPPES UpdateMay 12, 20212 updates tracked since enumeration
NPPES CertifiedMay 12, 2021
✔ NPI 1104364686 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
License✔ Licensed in NY · F341370-1
Also ListedRegistered NurseTaxonomy 163W00000X · License 611605 (NY)
5 PALISADES DRIVE SUITE 200, Albany, NY 12205
Open in Google Maps ↗

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Shannon Church 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 Reassignments

2

Medicare enrollment records show Shannon Church reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

St. Peter's Health Partners Medical Associates, P.C.
1.4 mi
Multi-Specialty
315 S MANNING BLVD
Albany, NY 12208
  • Reassigned Medicare billing, New York enrollment
  • 742 clinicians in this Medicare group
NPI 1750626834 (518) 525-5634
Signify Health Medical Associates, PLLC
1,424 mi
General Practice
4055 VALLEY VIEW LN STE 700
Dallas, TX 75244
  • Reassigned Medicare billing, North Carolina enrollment
  • 728 clinicians in this Medicare group
NPI 1750845863 (972) 715-3800

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 12205 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
$84.93 typical visit price
range $54.87 – $166.88
Typical copayment $21.23 (range $13.71 – $41.72)
Most-billed visit code 99203
Established Patient
$97.08 typical visit price
range $17.54 – $136.14
Typical copayment $24.27 (range $4.38 – $34.03)
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.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

Reported Quality Measures

Colorectal Cancer Screening
Percentage of adults 50-75 years of age who had appropriate screening for colorectal cancer
73%641 patients4/55-star benchmark: 85%
Diabetes: Eye Exam
Percentage of patients 18-75 years of age with diabetes who had a retinal or dilated eye exam by an eye care professional during the measurement period or a negative retinal exam (no evidence of retinopathy) in the 12 months prior to the measurement period
64%168 patients3/55-star benchmark: 100%
e-Prescribing
At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology.
98%3,168 patients4/55-star benchmark: 99%
Health Information Exchange
The MIPS eligible clinician that transitions or refers their patient to another setting of care or health care clinician (1) uses CEHRT to create a summary of care record; and (2) electronically transmits such summary to a receiving health care clinician for…
80%711 patients4/55-star benchmark: 88%
Medication Reconciliation
The MIPS eligible clinician performs medication reconciliation for at least one transition of care in which the patient is transitioned into the care of the MIPS eligible clinician.
99%590 patients4/55-star benchmark: 100%
Patient-Specific Education
The MIPS eligible clinician must use clinically relevant information from CEHRT to identify patient-specific educational resources and provide access to those materials to at least one unique patient seen by the MIPS eligible clinician.
91%1,524 patients4/55-star benchmark: 97%
Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan
Percentage of patients aged 18 years and older with a BMI documented during the current encounter or during the previous twelve months AND with a BMI outside of normal parameters, a follow-up plan is documented during the encounter or during the previous…
94%1,492 patients4/55-star benchmark: 97%
Provide Patient Access
At least one patient seen by the MIPS eligible clinician during the performance period is provided timely access to view online, download, and transmit to a third party their health information subject to the MIPS eligible clinician's discretion to withhold…
75%1,523 patients4/55-star benchmark: 100%
Secure Messaging
For at least one unique patient seen by the MIPS eligible clinician during the performance period, a secure message was sent using the electronic messaging function of CEHRT to the patient (or the patient-authorized representative), or in response to a secure…
15%1,523 patients1/55-star benchmark: 89%
View, Download, or Transmit (VDT)
At least one patient seen by the MIPS eligible clinician during the performance period (or patient-authorized representative) views, downloads or transmits their health information to a third party during the performance period.
40%1,523 patients
Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Referred Medical Equipment & Supplies CMS DME claims

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress E0260
DME-Hospital Beds · category DB000N
1 supplier12 claims12 services$28.51 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 3

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

ST. PETER'S HEALTH PARTNERS MEDICAL ASSOCIATES, P.C.
Internal Medicine
5 PALISADES DRIVE SUITE 200, ST PETER'S INTERNAL MEDICINE
ALBANY, NY 12205
Albany County (518) 438-0019
NERISSA ALFREDA SCOTT FNP-BC
Nurse Practitioner (Family)
5 PALISADES DRIVE SUITE 200, ST. PETER'S INTERNAL MEDICINE
ALBANY, NY 12205
Albany County (518) 438-0019
DR. JOHN M. BASHANT D.O.
Internal Medicine
5 PALISADES DRIVE SUITE 200, ST. PETER'S INTERNAL MEDICINE
ALBANY, NY 12205
Albany County (518) 438-0019

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 Shannon Church's NPI number?

The NPI number for Shannon Church is 1104364686. It was assigned to this individual provider in the NPPES registry on February 6, 2017.

Where is Shannon Church located?

Shannon Church practices at 5 Palisades Drive Suite 200 St. Peter's Internal Medicine, Albany, NY 12205. The listed phone number is (518) 438-0019.

What is Shannon Church's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Is Shannon Church enrolled in Medicare?

Yes. Shannon Church is registered in the Medicare PECOS enrollment system.

Which organizations bill Medicare for Shannon Church's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Shannon Church reassigns Medicare benefits to 2 organizations: St. Peter's Health Partners Medical Associates, P.C. (Albany, NY) and Signify Health Medical Associates, PLLC (Dallas, TX). Each 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 Shannon Church'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 Shannon Church was last updated on May 12, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.