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

Shannon Thomas

Individual provider Physician Assistant · NPI 1174260038

Shannon Thomas is a Physician Assistant in Staten Island, New York. Qualified in 2022, 4 years ago. Practices with North Shore-Lij Medical PC, a 6,350-clinician group and accepts Medicare assignment.

Years since qualifying
4
In the registry since
2022
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Practice location Address checks out

1 Campus Rd
Staten Island, NY 10301-4479
Phone: (718) 390-3100
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X

Record details

NPI number1174260038
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedMay 12, 2022
Last updated in NPPESMay 12, 2022
Certification dateMay 12, 2022

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2022 (4 years in practice)
Group practice North Shore-Lij Medical Pc — 6350 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations5 on file with Medicare

Other providers in Staten Island