SHANNON DOROTHEA VASSALLO PA
NPI 1114357274
Physician Assistant in Raleigh, NC

Q: What is Shannon Vassallo's NPI number?

The NPI number for Shannon Vassallo is 1114357274. It was assigned to this individual provider in the NPPES registry on November 26, 2013. The provider is also known as Shannon Nardozzi.

Q: What is Shannon Vassallo's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Q: When was this NPI record last updated?

The NPPES record for Shannon Vassallo was last updated on December 11, 2020. 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.

Active since November 26, 2013PECOS EnrolledAccepts Medicare Assignment

3801 WAKE FOREST RD STE 210, RALEIGH, NC 27609(919) 787-7246(919) 787-7247 Get Directions Write a Review

NPPES record last updated: December 11, 2020. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Dec 11, 2020, Jun 25, 2020, Apr 24, 2018 (3 updates tracked since 2018).

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About Shannon Dorothea Vassallo Pa NPPES

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

SHANNON DOROTHEA VASSALLO PA (NPI 1114357274) is an individual physician assistant in Raleigh, North Carolina, licensed in North Carolina (0010-04755) and active in the NPI registry since November 2013. She is enrolled in Medicare PECOS, is affiliated with Rex Hospital, and maintains a secondary practice location in Raleigh.

NPPES Registry Identity

NPI1114357274

Entity TypeIndividualFemale

Primary Taxonomy363A00000X

Provider Legal NameSHANNON DOROTHEA VASSALLOCredential: PA

Location Address3801 WAKE FOREST RD STE 210Raleigh, NC 27609-6864

Mailing Address3801 Wake Forest Rd Ste 210Raleigh, NC 27609-6864 · (919) 787-7246 · Fax (919) 787-7247

Phone(919) 787-7246

Fax(919) 787-7247

Sole ProprietorNo

Medical School CMSMercy CollegeGraduated 2013

Enumeration DateNovember 26, 2013

Last NPPES UpdateDecember 11, 20203 updates tracked since enumeration

NPPES CertifiedDecember 11, 2020

✔ NPI 1114357274 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363A00000X

License✔ Licensed in NC · 0010-04755

Definition

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

3801 WAKE FOREST RD STE 210, Raleigh, NC 27609

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Other Names 1

Former Name (1)Shannon Nardozzi

Secondary Practice Location 1

Location 14207 Lake Boone Trl Ste 220Raleigh, NC 27607-6685 · Phone (919) 784-1410

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of NC, UnitedHealthcare.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Shannon Dorothea Vassallo Pa is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID8820229784

PECOS Enrollment IDI20140319000430

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.

Areas of Expertise CMS Part B claims

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Partial removal of spine bone with release of lower spinal cord and/or nerves, 1 segment 63047

This procedure involves removing part of a spine bone to alleviate pressure on the lower spinal cord and/or nerves. It targets a single segment of the spine, improving mobility and reducing pain. It's a common treatment for conditions like herniated discs or spinal stenosis.

24 services24 patients

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Rex Hospital

Acute Care Hospitals · Raleigh, NC

5/5 CMS rating

OwnershipGovernment - State

CMS Certification Number340114

Location4420 Lake Boone TrailRaleigh, NC 27607 · Wake County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 27609 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

$83.90 typical visit price

range $54.12 – $165.09

Typical copayment $20.97 (range $13.53 – $41.27)

Most-billed visit code 99203

Established Patient

$67.72 typical visit price

range $17.21 – $134.61

Typical copayment $16.93 (range $4.30 – $33.65)

Most-billed visit code 99213

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 7

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

COLLEEN PAWLAK NP

Nurse Practitioner (Family)