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Deactivated NPI 1104826031 Deactivated / Inactive NPI Female Practitioner

Dr. Shannon L Bongers , MD

Surgery • Plano, TX

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Dr. Shannon Bongers has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date July 21, 2005
NPI Deactivation Date December 02, 2020
Total Practice Duration ~15 Years of Practice (2005 – 2020)

Professional Overview & Biography Verified Profile Summary

Dr. Shannon Bongers, MD was a registered Surgery practicing in Plano, TX. Throughout an active medical career spanning 15 years, Dr. Bongers provided care at the practice location at 4001 W 15TH ST until profile deactivation on 2020-12-02.

Historical Medicare Part B clinical services included established patient outpatient office visit, partial removal of breast, lymph node imaging during surgery. Public procedure reimbursement records and service volume details are provided below for historical transparency.

Practice Location & Contact Primary Location

Practice Address

4001 W 15th St
Ste 180

Plano, TX 750935841

Telephone 9725965225
Fax 9729859782
Associated Practice Facility / Clinic
🏢 Plano Pediatrics Pa Facility NPI 1538239496

Specialty Benchmarks & Practice Insights

Comparative analytics for Surgery in Plano, TX

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 27.3 Yrs
State Avg: 25.2 Yrs
Regional Practice Density
50 Specialists

Practicing in Plano, TX (2342 Statewide)

Telehealth Adoption Rate
4.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
44.3% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2019)
Reporting Year:
HCPCS Code & Description Services Patients Submitted Charge Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes
63 61 $107.00 $75.75
19301 Partial removal of breast
16 13 $1342.00 $730.99

Medical Specialties & State Licenses

Surgery Primary Specialty

NUCC Taxonomy Code: 208600000X

State License TX K8015

A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

4 Associated Practitioners
NPI 1053311993

Doctor of Medicine (M.D.)

NPI 1306009659

Doctor of Medicine (M.D.)

Deborah Burns , MS CRNFA FNP-C

Nurse Practitioner - Family

NPI 1437197308

MSCRNFAFNPC

NPI 1710947361

Doctor of Medicine (M.D.)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

12 Historical Events
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NPI Profile Deactivated December 02, 2020

Record deactivated on December 02, 2020

NPI Profile Active May 22, 2017

NPI status registered as active in NPPES database

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Updated Practice Location May 22, 2017

Registered at 3601 W 13 MILE RD, ROYAL OAK, MI 480736712 (Tel: 2485513300)

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Updated Business Mailing Address May 22, 2017

Registered at 130 TOWN CENTER DRIVE, 203, TROY, MI 480841744

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Provider Name / Credentials Updated May 22, 2017

Recorded as SHANNON BONGERS, MD

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Medical Taxonomy / Specialty Registered (Primary Specialty) May 22, 2017

Surgery (License #4301054892 in MI)

NPI Profile Active July 08, 2007

NPI status registered as active in NPPES database

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Updated Practice Location July 08, 2007

Registered at 4001 W 15TH ST, STE 180, PLANO, TX 750935841 (Tel: 9725965225)

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Updated Business Mailing Address July 08, 2007

Registered at 4001 W 15TH ST, STE 180, PLANO, TX 750935841 (Tel: 9725965225)

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Provider Name / Credentials Updated July 08, 2007

Recorded as SHANNON BONGERS, M.D.

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Medical Taxonomy / Specialty Registered (Primary Specialty) July 08, 2007

Surgery (License #K8015 in TX)

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Initial NPI Registration & Enumeration July 21, 2005

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1104826031
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: July 21, 2005
Last Update: July 08, 2007
Deactivation Date: December 02, 2020

Mailing Address

4001 W 15th St, Ste 180

Plano, TX 750935841

Phone: 9725965225

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.