SHANE STEPHEN HARRIS PA
NPI 1528762879
Physician Assistant in Libertyville, IL

Q: What is Shane Harris's NPI number?

The NPI number for Shane Harris is 1528762879. It was assigned to this individual provider in the NPPES registry on March 29, 2023.

Q: What is Shane Harris'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 Shane Harris was last updated on September 18, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 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 March 29, 2023PECOS EnrolledAccepts Medicare Assignment

1860 W WINCHESTER RD STE 106, LIBERTYVILLE, IL 60048(847) 816-6335 Get Directions Write a Review

NPPES record last updated: September 18, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Sep 18, 2025, Mar 29, 2023 (2 updates tracked since 2023).

On this page

About Shane Stephen Harris Pa NPPES

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

SHANE STEPHEN HARRIS PA (NPI 1528762879) is an individual physician assistant in Libertyville, Illinois, licensed in Illinois (085.009911) and active in the NPI registry since March 2023. He is enrolled in Medicare PECOS, is affiliated with Advocate Condell Medical Center, and maintains a secondary practice location in Pleasant Prairie.

NPPES Registry Identity

NPI1528762879

Entity TypeIndividualMale

Primary Taxonomy363A00000X

Provider Legal NameSHANE STEPHEN HARRISCredential: PA

Location Address1860 W WINCHESTER RD STE 106Libertyville, IL 60048-5312

Mailing Address1860 W Winchester Rd Ste 106Libertyville, IL 60048-5312 · (847) 816-6335

Phone(847) 816-6335

Sole ProprietorYes

Medical School CMSOtherGraduated 2023

Enumeration DateMarch 29, 2023

Last NPPES UpdateSeptember 18, 20252 updates tracked since enumeration

NPPES CertifiedSeptember 18, 2025

✔ NPI 1528762879 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363A00000X

Licenses✔ Licensed in IL · 085.009911✔ Licensed in WI · 8293

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.

1860 W WINCHESTER RD STE 106, Libertyville, IL 60048

Open in Google Maps ↗

Secondary Practice Location 1

Location 19555 76th St Fl 2Pleasant Prairie, WI 53158-1984 · Phone (262) 577-8300

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Network Health.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

Shane Stephen Harris 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 ID4183069099

PECOS Enrollment IDI20240301002175, I20250916003014

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 2

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

Advocate Condell Medical Center

Acute Care Hospitals · Libertyville, IL

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number140202

Location801 S Milwaukee AveLibertyville, IL 60048 · Lake County

Emergency services Birthing friendly

Froedtert South Inc.

Acute Care Hospitals · Pleasant Prairie, WI

1/5 CMS rating

OwnershipGovernment - Local

CMS Certification Number520021

Location9555 76th StPleasant Prairie, WI 53158 · Kenosha County

Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 60048 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

$93.02 typical visit price

range $59.81 – $181.38

Typical copayment $23.25 (range $14.95 – $45.34)

Most-billed visit code 99203

Established Patient

$74.38 typical visit price

range $19.15 – $147.12

Typical copayment $18.59 (range $4.78 – $36.78)

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 17

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

NICOLE JACQUES LSW

Psychiatry & Neurology (Psychiatry)