SHANNON TREVINO NP
NPI 1407112055
Nurse Practitioner in Waltham, MA

Active since April 09, 2012PECOS Enrolled
221 CRESCENT ST STE 202, WALTHAM, MA 02453(866) 849-0692 Get Directions Write a Review

NPPES record last updated: March 16, 2023. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: May 14, 2025, Jan 10, 2025, Dec 12, 2024 and 7 more (10 updates tracked since 2018).

About Shannon Trevino Np NPPES

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

SHANNON TREVINO NP (NPI 1407112055) is an individual nurse practitioner in Waltham, Massachusetts, licensed in Colorado (0994056) and active in the NPI registry since April 2012. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1407112055
Entity TypeIndividualFemale
Primary Taxonomy363L00000X
Provider Legal NameSHANNON TREVINOCredential: NP
Location Address221 CRESCENT ST STE 202Waltham, MA 02453-3425
Mailing AddressPo Box 211699Eagan, MN 55121-3699 · (866) 849-0692
Sole ProprietorNo
Enumeration DateApril 9, 2012
Last NPPES UpdateMarch 16, 202310 updates tracked since enumeration
NPPES CertifiedMarch 16, 2023
NPI 1407112055 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtyNurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363L00000X
License Licensed in CO · 0994056
Definition

(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.

Also ListedRegistered NurseTaxonomy 163W00000X · License 183243 (CO), 760780 (CA)
221 CRESCENT ST STE 202, Waltham, MA 02453

Other Names 1

Former Name (1)Shannon Lenahan Rn

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

Enrolled in Medicare (PECOS)

Shannon Trevino Np 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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 02453 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
$97.64 typical visit price
range $63.72 – $189.86
Typical copayment $24.41 (range $15.93 – $47.46)
Most-billed visit code 99203
Established Patient
$111.18 typical visit price
range $21.07 – $155.29
Typical copayment $27.79 (range $5.26 – $38.82)
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 12

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

Registered Nurse (Case Management)
221 CRESCENT ST STE 202
WALTHAM, MA 02453
Registered Nurse
221 CRESCENT ST STE 202
WALTHAM, MA 02453
Health Maintenance Organization
221 CRESCENT ST STE 202
WALTHAM, MA 02453
Health Maintenance Organization
221 CRESCENT ST STE 202
WALTHAM, MA 02453
Health Maintenance Organization
221 CRESCENT ST STE 202
WALTHAM, MA 02453
Health Maintenance Organization
221 CRESCENT ST STE 202
WALTHAM, MA 02453
Pharmacist (Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist)
221 CRESCENT ST STE 202
WALTHAM, MA 02453
Health Maintenance Organization
221 CRESCENT ST STE 202
WALTHAM, MA 02453

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1407112055, enumerated as an "individual" on April 09, 2012.

The provider is located at 221 CRESCENT ST STE 202 WALTHAM, MA 02453 and the phone number is (866) 849-0692.

Nurse Practitioner with taxonomy code 363L00000X.