Shannon Lyn Bongers (NPI# 1104826031, PAC ID# 7416965074) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is GENERAL SURGERY.
| Nation Provider ID (NPI) | 1104826031 |
| PAC ID by PECOS | 7416965074 |
| Professional Enrollment ID | I20060323000727 |
| Full Name | Shannon Lyn Bongers |
| Organization Legal Name | BEAUMONT MEDICAL GROUP SPECIALTY SERVICES |
| Address |
3601 W 13 Mile Rd Bcc Beaumont Breast Care Center Royal Oak MI 48073-6712 |
| Phone Number | 2485513300 |
| Gender | F |
| Credential | MD |
| Medical School | WAYNE STATE UNIVERSITY SCHOOL OF MEDICINE |
| Graduation Year | 1989 |
| Primary Specialty | GENERAL SURGERY |
| Group Practice PAC ID | 7214299866 |
| Number of Group Practice Members | 326 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 230130 | BEAUMONT HOSPITAL, ROYAL OAK |
| 230269 | BEAUMONT HOSPITAL, TROY |
| Address | Phone | Organization |
|---|---|---|
| 3601 W 13 Mile Rd Bcc, Beaumont Breast Care Center, Royal Oak, MI 48073-6712 | 2485513300 | BEAUMONT MEDICAL GROUP SPECIALTY SERVICES |
| Measure Identifier | Measure Title | Performance Rate | Reporting Mechanism |
|---|---|---|---|
| MIPS_EC_039_overall | Screening for Osteoporosis for Women Aged 65-85 Years of Age | 52% | |
| MIPS_EC_110_overall | Preventive Care and Screening: Influenza Immunization | 21% | |
| MIPS_EC_111_overall | Pneumococcal Vaccination Status for Older Adults | 35% | |
| MIPS_EC_113_overall | Colorectal Cancer Screening | 23% | |
| MIPS_EC_128_overall | Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan | 37% | |
| MIPS_EC_130_overall | Documentation of Current Medications in the Medical Record | 88% | |
| MIPS_EC_226_overall | Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention | 86% |
| Organization Legal Name | BEAUMONT MEDICAL GROUP SPECIALTY SERVICES |
| Physicians | 16 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Young Ah Lee | Pediatric Medicine | Beaumont Medical Group Specialty Services | 25250 Kelly Rd, Suite 100, Roseville, MI 48066-4473 |
| Jenna May Kim | Ophthalmology | Beaumont Medical Group Specialty Services | 25250 Kelly Rd, Suite 100, Roseville, MI 48066-4473 |
| Thomas D Magnell | Orthopedic Surgery | Beaumont Medical Group Specialty Services | 25250 Kelly Rd, Suite 100, Roseville, MI 48066-4473 |
| Charles Main | Pediatric Medicine | Beaumont Medical Group Specialty Services | 25250 Kelly Rd, Suite 100, Roseville, MI 48066-4473 |
| Jeffrey M Altshuler | Cardiac Surgery | Beaumont Medical Group Specialty Services | 25250 Kelly Rd, Suite 100, Roseville, MI 48066-4473 |
| Darrell D Vlachos | Emergency Medicine | Beaumont Medical Group Specialty Services | 25250 Kelly Rd, Suite 100, Roseville, MI 48066-4473 |
| Pramote Laoprasert | Neurology | Beaumont Medical Group Specialty Services | 25250 Kelly Rd, Suite 100, Roseville, MI 48066-4473 |
| Dotun A Ogunyemi | Obstetrics/gynecology | Beaumont Medical Group Specialty Services | 25250 Kelly Rd, Suite 100, Roseville, MI 48066-4473 |
| Prem V Khilanani | Hematology/oncology | Beaumont Medical Group Specialty Services | 25250 Kelly Rd, Suite 100, Roseville, MI 48066-4473 |
| Mouhib Ayas | Pediatric Medicine | Beaumont Medical Group Specialty Services | 25250 Kelly Rd, Suite 100, Roseville, MI 48066-4473 |
| Street Address |
3601 W 13 MILE RD BCC BEAUMONT BREAST CARE CENTER |
| City | ROYAL OAK |
| State | MI |
| Zip | 48073-6712 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Sayee Hardas Kiran | General Surgery | Beaumont Medical Group-specialty Services | 3601 W 13 Mile Rd Bcc, Beaumont Breast Care Center, Royal Oak, MI 48073-6712 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Patrick Robert Pierce | Physical Therapy | Farmington Physical Therapy Inc | 29480 Woodward Ave, Royal Oak, MI 48073-0903 |
| Michael Leither | Physical Therapy | Farmington Physical Therapy Inc | 29480 Woodward Ave, Royal Oak, MI 48073-0903 |
| Leython Williams | Physical Therapy | Farmington Physical Therapy Inc | 29480 Woodward Ave, Royal Oak, MI 48073-0903 |
| Amanda Marleen Pfost | Physical Therapy | Farmington Physical Therapy Inc | 29480 Woodward Ave, Royal Oak, MI 48073-0903 |
| Donald Frederick Moylan | Urology | Comprehensive Medical Center, Pllc | 31157 Woodward Ave, Royal Oak, MI 48073-0926 |
| Michal W Wiercigroch | Physical Therapy | Michigan Rehabilitation Specialists of Fowlerville LLC | 31372 Woodward Ave, Ati Physical Therapy, Royal Oak, MI 48073-0929 |
| Stephanie H Walton | Physical Therapy | Michigan Rehabilitation Specialists of Fowlerville LLC | 31372 Woodward Ave, Ati Physical Therapy, Royal Oak, MI 48073-0929 |
| Allison Tyler | Physical Therapy | Michigan Rehabilitation Specialists of Fowlerville LLC | 31372 Woodward Ave, Ati Physical Therapy, Royal Oak, MI 48073-0929 |
| Caitlin Bennett | Physical Therapy | Michigan Rehabilitation Specialists of Fowlerville LLC | 31372 Woodward Ave, Ati Physical Therapy, Royal Oak, MI 48073-0929 |
| Chelsea Hazel Bartholomew | Physical Therapy | Michigan Rehabilitation Specialists of Fowlerville LLC | 31372 Woodward Ave, Ati Physical Therapy, Royal Oak, MI 48073-0929 |
| Find all physicians in zip 48073 | |||
| City | ROYAL OAK |
| Zip Code | 48073 |
| Specialty | GENERAL SURGERY |
| City + Specialty | ROYAL OAK + GENERAL SURGERY |
Please comment or provide details below to improve the information on Shannon Lyn Bongers.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.