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MR. ERASTUS SHANNON PMH-NP
NPI 1710695762
Nurse Practitioner - Psychiatric/Mental Health in Albany, NY

Active since November 08, 2022PECOS Enrolled
418 BROADWAY STE N, ALBANY, NY 12207(516) 200-6865 Get Directions Write a Review

NPPES record last updated: November 8, 2022. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Mr. Erastus Shannon Pmh-np NPPES

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

MR. ERASTUS SHANNON PMH-NP (NPI 1710695762) is an individual psychiatric/mental health provider in Albany, New York, licensed in New York (404594) and active in the NPI registry since November 2022. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1710695762
Entity TypeIndividualMale
Primary Taxonomy363LP0808X
Provider Legal NameMR. ERASTUS SHANNONCredential: PMH-NP
Location Address418 BROADWAY STE NAlbany, NY 12207-2922
Mailing Address418 Broadway Ste NAlbany, NY 12207-2922 · (516) 200-6865
Phone(516) 200-6865
Sole ProprietorYes
Enumeration DateNovember 8, 2022
NPPES CertifiedNovember 8, 2022
✔ NPI 1710695762 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · Psychiatric/Mental HealthPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LP0808X
License✔ Licensed in NY · 404594
418 BROADWAY STE N, Albany, NY 12207
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mr. Erastus Shannon Pmh-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.

Medicare Billing Reassignments

2

Medicare enrollment records show Erastus Shannon reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Charles Evans Center, Inc
124 mi
Mental Health (Including Community Mental Health Center)
113 GLEN COVE AVE
Glen Cove, NY 11542
  • Reassigned Medicare billing, New York enrollment
  • 66 clinicians in this Medicare group
NPI 1770142366 (516) 676-2388
Family Service League, Inc.
125 mi
Community/Behavioral Health
790 PARK AVE
Huntington, NY 11743
  • Reassigned Medicare billing, New York enrollment
  • 122 clinicians in this Medicare group
NPI 1528093242 (631) 427-3700

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 12207 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.

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.

CHRISTINA ERCOLE NP IN PSYCHIATRY, PLLC
Nurse Practitioner (Psychiatric/Mental Health)
418 BROADWAY STE N
ALBANY, NY 12207
Albany County (914) 987-3740
RELATYV MOBILE MEDICAL LLC
Specialist/Technologist, Other
418 BROADWAY STE N
ALBANY, NY 12207
Albany County (866) 914-1070
DODSON THERAPY ASSOCIATES, LLC
Social Worker (Clinical)
418 BROADWAY STE N
ALBANY, NY 12207
Albany County (845) 600-0969
FIREFLIES HEALING CENTER
Clinic/Center (Mental Health (Including Community Mental Health Center))
418 BROADWAY STE N
ALBANY, NY 12207
Albany County (865) 964-3780
RACHEL WOJCICKI MS, MPH
Nutritionist
418 BROADWAY STE N
ALBANY, NY 12207
Albany County (716) 276-0359
DEARIE PREVENTATIVE MEDICINE PROFESSIONAL CORPORATION
Preventive Medicine (Public Health & General Preventive Medicine)
418 BROADWAY STE N
ALBANY, NY 12207
Albany County (206) 486-2053
INSPIRE CORE PT PLLC
Clinic/Center (Physical Therapy)
418 BROADWAY STE N
ALBANY, NY 12207
Albany County (646) 727-0420
HOMESERV CARE & COORDINATION LLC
Case Manager/Care Coordinator
418 BROADWAY STE N
ALBANY, NY 12207
Albany County (917) 831-7846

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 Erastus Shannon's NPI number?

The NPI number for Erastus Shannon is 1710695762. It was assigned to this individual provider in the NPPES registry on November 8, 2022.

Where is Erastus Shannon located?

Erastus Shannon practices at 418 Broadway Ste N, Albany, NY 12207. The listed phone number is (516) 200-6865.

What is Erastus Shannon's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.

Is Erastus Shannon enrolled in Medicare?

Yes. Erastus Shannon is registered in the Medicare PECOS enrollment system.

Which organizations bill Medicare for Erastus Shannon's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Erastus Shannon reassigns Medicare benefits to 2 organizations: Charles Evans Center, Inc (Glen Cove, NY) and Family Service League, Inc. (Huntington, NY). Each 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 Erastus Shannon'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 Erastus Shannon was last updated on November 8, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.