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

Shane R O'Neil, PA

Individual provider Physician Assistant · NPI 1922350073

Shane R O'Neil, PA is a Physician Assistant in Johnson City, New York. Qualified in 2012, 14 years ago. Practices with New Season Dermatology PLLC, a 7-clinician group and accepts Medicare assignment. Licensed in North Carolina and New York.

Years since qualifying
14
Licensed in
NC, NY
In the registry since
2012
Specialties on file
2
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

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Practice location Address checks out

302 Reynolds Rd Ste A
Johnson City, NY 13790-1308
Phone: (607) 444-5446
Fax: (607) 444-5447
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 016116 (NY)
Physician Assistant Taxonomy 363A00000X · Licence 0010-08374 (NC)

Record details

NPI number1922350073
Entity typeIndividual (Type 1)
GenderMale
Credentials PA
Sole proprietorYes
NPI enumeratedOctober 12, 2012
Last updated in NPPESOctober 9, 2025
Certification dateOctober 9, 2025

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2012 (14 years in practice)
Group practice New Season Dermatology Pllc — 7 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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