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

Shannon Kelly Quackenbush, CRNA

Individual provider Registered Nurse · NPI 1730709486

Shannon Kelly Quackenbush, CRNA is a Certified Registered Nurse Anesthetist (CRNA) in Buffalo, New York. Qualified in 2011, 15 years ago. Practices with Premier Anesthesia of New York, PC, a 49-clinician group and accepts Medicare assignment. Licensed in Arizona, New York and Pennsylvania.

Years since qualifying
15
Licensed in
AZ, NY, PA
In the registry since
2020
Specialties on file
3
What do these letters mean?
CRNA — Certified Registered Nurse Anesthetist
An advanced practice nurse who administers anaesthesia.

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Practice location Address checks out

1001 Main St Ste K-3502
Buffalo, NY 14203-1009
Phone: (716) 323-6658
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Certified Registered Nurse Anesthetist (primary) Taxonomy 367500000X · Licence 748921-1 (NY)
Registered Nurse Taxonomy 163W00000X · Licence RN178240 (AZ)
Certified Registered Nurse Anesthetist Taxonomy 367500000X · Licence RN629994 (PA)

Record details

NPI number1730709486
Entity typeIndividual (Type 1)
GenderFemale
Credentials CRNA
Sole proprietorNo
NPI enumeratedApril 23, 2020
Last updated in NPPESAugust 1, 2025
Certification dateAugust 1, 2025

Medicare enrollment

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

Medicare specialtyCERTIFIED REGISTERED NURSE ANESTHETIST (CRNA)
Medical schoolOTHER
Graduated 2011 (15 years in practice)
Group practice Premier Anesthesia Of New York, P.C. — 49 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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