1. Home
  2. Directory
  3. New York
  4. Amherst
  5. Nurse Practitioner
  6. NPI Profile

SHELLEY MAE BACON NP
NPI 1669966065
Nurse Practitioner - Family in Amherst, NY

Active since June 19, 2018PECOS Enrolled
4979 HARLEM RD, AMHERST, NY 14226(716) 923-4380(716) 923-4384 Get Directions Write a Review

NPPES record last updated: June 19, 2018. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Shelley Mae Bacon Np NPPES

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

SHELLEY MAE BACON NP (NPI 1669966065) is an individual family provider in Amherst, New York, licensed in New York (342993) and active in the NPI registry since June 2018. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1669966065
Entity TypeIndividualFemale
Primary Taxonomy363LF0000X
Provider Legal NameSHELLEY MAE BACONCredential: NP
Location Address4979 HARLEM RDAmherst, NY 14226-2547
Mailing Address4979 Harlem RdAmherst, NY 14226-2547 · (716) 923-4380
Phone(716) 923-4380
Fax(716) 923-4384
Sole ProprietorNo
Enumeration DateJune 19, 2018
✔ NPI 1669966065 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
License✔ Licensed in NY · 342993
4979 HARLEM RD, Amherst, NY 14226
Open in Google Maps ↗

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Shelley Mae Bacon 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 14226 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
$84.93 typical visit price
range $54.87 – $166.88
Typical copayment $21.23 (range $13.71 – $41.72)
Most-billed visit code 99203
Established Patient
$97.08 typical visit price
range $17.54 – $136.14
Typical copayment $24.27 (range $4.38 – $34.03)
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.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

Reported Quality Measures

Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan
Percentage of patients aged 18 years and older with a BMI documented during the current encounter or during the previous twelve months AND with a BMI outside of normal parameters, a follow-up plan is documented during the encounter or during the previous…
100%31 patients5/55-star benchmark: 100%
Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

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. PAUL C DIPPERT DO
Family Medicine
4979 HARLEM RD
AMHERST, NY 14226
Erie County (716) 923-4380
RIFFAT SADIQ M.D.
Internal Medicine
4979 HARLEM RD, SUITE 1
AMHERST, NY 14226
Erie County (716) 923-4380
CLARICE M HART NP
Nurse Practitioner (Adult Health)
4979 HARLEM RD
AMHERST, NY 14226
Erie County (716) 923-4380
RAZIA SULTANA MD PHD
Internal Medicine
4979 HARLEM RD
AMHERST, NY 14226
Erie County (716) 923-4380
NAWAL A MOALLIM PA-C
Physician Assistant
4979 HARLEM RD
AMHERST, NY 14226
Erie County (716) 923-4381
WNY MEDICAL PC
Internal Medicine
4979 HARLEM RD
AMHERST, NY 14226
Erie County (716) 923-4380
MRS. JAMEELA YASMEEN KHAN RPA-C
Physician Assistant
4979 HARLEM RD, SUITE 1
AMHERST, NY 14226
Erie County (716) 923-4380
TOM MATHEW M.D.
Internal Medicine
4979 HARLEM RD, SUITE 1
AMHERST, NY 14226
Erie County (716) 923-4380

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 Shelley Bacon's NPI number?

The NPI number for Shelley Bacon is 1669966065. It was assigned to this individual provider in the NPPES registry on June 19, 2018.

Where is Shelley Bacon located?

Shelley Bacon practices at 4979 Harlem Rd, Amherst, NY 14226. The listed phone number is (716) 923-4380.

What is Shelley Bacon's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Is Shelley Bacon enrolled in Medicare?

Yes. Shelley Bacon is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Shelley Bacon was last updated on June 19, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 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.