Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Ian Shannon

Individual provider Nurse Practitioner · NPI 1679461818

Ian Shannon is a Nurse Practitioner in Rochester, New York. Qualified in 2025, 1 year ago. Practices with Endocrine Practice Group, a 25-clinician group, accepts Medicare assignment and offers telehealth. Licensed in New York.

Years since qualifying
1
Licensed in
NY
In the registry since
2025
Specialties on file
2
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Practice location Address checks out

601 Elmwood Ave Fl 3
Rochester, NY 14642-0001
Phone: (585) 275-2901
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Nurse Practitioner (primary) Taxonomy 363L00000X · Licence 312441 (NY)
Registered Nurse Taxonomy 163W00000X · Licence 795387 (NY)

Record details

NPI number1679461818
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedJune 26, 2025
Last updated in NPPESAugust 22, 2025
Certification dateAugust 22, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2025 (1 years in practice)
Group practice Endocrine Practice Group — 25 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

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