SHANNON DWYER
NPI 1285179895
Nurse Practitioner - Psychiatric/Mental Health in Palo Alto, CA
About Shannon Dwyer NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
SHANNON DWYER (NPI 1285179895) is an individual psychiatric/mental health provider in Palo Alto, California, licensed in California (95005786) and active in the NPI registry since January 2017. She is enrolled in Medicare PECOS and is a graduate of Other (2016).
NPPES Registry Identity
Specialties & Licenses
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Shannon Dwyer 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.
Medicare Billing Reassignment
Medicare enrollment records show Shannon Dwyer reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Los Angeles, CA 90064
- Reassigned Medicare billing, California enrollment
- 53 clinicians in this Medicare group
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 94301 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
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 Dwyer's NPI number?
The NPI number for Shannon Dwyer is 1285179895. It was assigned to this individual provider in the NPPES registry on January 5, 2017.
Where is Shannon Dwyer located?
Shannon Dwyer practices at 115 Everett Ave, Palo Alto, CA 94301. The listed phone number is (650) 690-2757.
What is Shannon Dwyer's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.
Is Shannon Dwyer enrolled in Medicare?
Yes. Shannon Dwyer 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.
Which organization bills Medicare for Shannon Dwyer's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Shannon Dwyer reassigns Medicare benefits to Executive Mental Health, Inc. (Los Angeles, CA). 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 Shannon Dwyer'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 Dwyer was last updated on January 5, 2017. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 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.
# Shannon Dwyer · NPI 1285179895
Psychiatric/Mental Health physician in Palo Alto, California. Individual provider, active in the CMS NPPES registry since January 5, 2017.
## Identity
- **NPI:** 1285179895 (Entity type: Individual)
- **Enumerated:** January 5, 2017
- **Primary specialty:** Nurse Practitioner - Psychiatric/Mental Health · taxonomy 363LP0808X
- **State license:** 95005786 (California)
- **Sole proprietor:** No
## Practice location
- **Address:** 115 EVERETT AVE, Palo Alto, CA 94301-1031
- **Phone:** (650) 690-2757
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** Executive Mental Health, Inc. (NPI 1275670036, Los Angeles, CA), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2016
## Record status
- **NPPES last updated:** January 5, 2017
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Source: [NPI Profile](https://npiprofile.com/npi/1285179895) · Data from the CMS NPPES public registry.