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SHANNON MARIE STOLL PAC
NPI 1144896879
Physician Assistant - Surgical in Portland, OR

Active since June 02, 2021PECOS EnrolledAccepts Medicare Assignment
4805 NE GLISAN ST # 6N60, PORTLAND, OR 97213(503) 281-0561 Get Directions Write a Review

NPPES record last updated: April 21, 2026. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Apr 21, 2026, Nov 6, 2024, Dec 7, 2023 and 6 more (9 updates tracked since 2021).

About Shannon Marie Stoll Pac NPPES

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

SHANNON MARIE STOLL PAC (NPI 1144896879) is an individual surgical provider in Portland, Oregon, licensed in Oregon (PA206024) and active in the NPI registry since June 2021. She is enrolled in Medicare PECOS, is affiliated with Providence Portland Medical Center, and maintains a secondary practice location in Beaverton.

NPPES Registry Identity

NPI1144896879
Entity TypeIndividualFemale
Primary Taxonomy363AS0400X
Provider Legal NameSHANNON MARIE STOLLCredential: PAC
Location Address4805 NE GLISAN ST # 6N60Portland, OR 97213-2933
Mailing Address541 Ne 20th Ave Ste 225Portland, OR 97232-2895 · (503) 963-2801 · Fax (503) 963-2825
Phone(503) 281-0561
Sole ProprietorYes
Medical School CMSOtherGraduated 2021
Enumeration DateJune 2, 2021
Last NPPES UpdateApril 21, 20269 updates tracked since enumeration
NPPES CertifiedApril 21, 2026
✔ NPI 1144896879 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPhysician Assistant · SurgicalPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363AS0400X
License✔ Licensed in OR · PA206024
Also ListedPhysician AssistantTaxonomy 363A00000X · License PA206024 (OR)
4805 NE GLISAN ST # 6N60, Portland, OR 97213
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Secondary Practice Location 1

Location 111000 SW Stratus St Ste 205Beaverton, OR 97008-7104 · Phone (503) 281-0561 · Fax (503) 416-7377

Other Identifiers 2

Medicaid500796288OR
Medicaid2182305WA

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include BridgeSpan Health Company, Moda Health Plan, Inc., Providence Health Plan and more.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 Marie Stoll Pac 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 ID1557765054
PECOS Enrollment IDI20210805001245
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.

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
26 services25 patients

Hospital Affiliations CMS Care Compare

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

Providence Portland Medical Center

Acute Care Hospitals · Portland, OR
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number380061
Location4805 NE Glisan StreetPortland, OR 97213 · Multnomah County
Emergency services Birthing friendly

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 Stoll's NPI number?

The NPI number for Shannon Stoll is 1144896879. It was assigned to this individual provider in the NPPES registry on June 2, 2021.

Where is Shannon Stoll located?

Shannon Stoll practices at 4805 NE Glisan St # 6n60, Portland, OR 97213. The listed phone number is (503) 281-0561.

What is Shannon Stoll's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Surgical, with taxonomy code 363AS0400X.

Is Shannon Stoll enrolled in Medicare?

Yes. Shannon Stoll is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Shannon Stoll accept?

Health plans from BridgeSpan Health Company, Moda Health Plan, Inc., Providence Health Plan and Regence BlueCross BlueShield of Oregon list Shannon Stoll as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Shannon Stoll affiliated with any hospitals?

According to CMS data, Shannon Stoll is affiliated with Providence Portland Medical Center.

When was this NPI record last updated?

The NPPES record for Shannon Stoll was last updated on April 21, 2026. NPI Profile syncs with the weekly NPPES data releases published by CMS.