SHANNON SMITH PA-C
NPI 1417792912
Physician Assistant in Woodbury, MN

Q: What is Shannon Smith's NPI number?

The NPI number for Shannon Smith is 1417792912. It was assigned to this individual provider in the NPPES registry on June 26, 2024.

Q: What is Shannon Smith'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 Smith was last updated on October 30, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 21 months 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 June 26, 2024PECOS EnrolledAccepts Medicare Assignment

8675 VALLEY CREEK RD, WOODBURY, MN 55125(651) 241-3000 Get Directions Write a Review

NPPES record last updated: October 30, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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About Shannon Smith Pa-c NPPES

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

SHANNON SMITH PA-C (NPI 1417792912) is an individual physician assistant in Woodbury, Minnesota and active in the NPI registry since June 2024. She is enrolled in Medicare PECOS, is affiliated with Cambridge Medical Center, and is a graduate of Other (2024).

NPPES Registry Identity

NPI1417792912

Entity TypeIndividualFemale

Primary Taxonomy363A00000X

Provider Legal NameSHANNON SMITHCredential: PA-C

Location Address8675 VALLEY CREEK RDWoodbury, MN 55125-2337

Mailing Address8675 Valley Creek RdWoodbury, MN 55125-2337 · (651) 241-3000

Phone(651) 241-3000

Sole ProprietorYes

Medical School CMSOtherGraduated 2024

Enumeration DateJune 26, 2024

Last NPPES UpdateOctober 30, 2024

NPPES CertifiedOctober 30, 2024

✔ NPI 1417792912 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363A00000X

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.

8675 VALLEY CREEK RD, Woodbury, MN 55125

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include HealthPartners, Medica.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 Smith Pa-c 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 ID2365989910

PECOS Enrollment IDI20240801000817

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.

Hospital Affiliations CMS Care Compare 4

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

Cambridge Medical Center

Acute Care Hospitals · Cambridge, MN

5/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number240020

Location701 South Dellwood AvenueCambridge, MN 55008 · Isanti County

Emergency services

Allina United Hospital

Acute Care Hospitals · Saint Paul, MN

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number240038

Location333 North Smith AvenueSaint Paul, MN 55102 · Ramsey County

Emergency services Birthing friendly

Abbott Northwestern Hospital

Acute Care Hospitals · Minneapolis, MN

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number240057

Location800 East 28th StreetMinneapolis, MN 55407 · Hennepin County

Emergency services Birthing friendly

Mercy Hospital

Acute Care Hospitals · Coon Rapids, MN

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number240115

Location4050 Coon Rapids BlvdCoon Rapids, MN 55433 · Anoka County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 55125 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

$85.82 typical visit price

range $56.00 – $168.28

Typical copayment $21.45 (range $14.00 – $42.07)

Most-billed visit code 99203

Established Patient

$69.74 typical visit price

range $18.32 – $138.04

Typical copayment $17.43 (range $4.58 – $34.51)

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 20

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

DR. DAVID SHRAKE D.O.

Family Medicine