Active NPI
Darren M Shafer, DO
- Emergency Medicine Physician
- Albuquerque, NM
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Medicine Physician
- License
- A-1264-04
- Practice address
- PMG Emergency Medicine
1101 Central SE
Albuquerque, NM 87106 - Phone
- (505) 841-1125
- Fax
- (505) 841-1737
- NPI assigned
- Oct 4, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | A-1264-04 | NM | Primary |
Addresses
Primary practice location
PMG Emergency Medicine
1101 Central SE
Albuquerque, NM 87106
Mailing address
PO Box 26666
PHS Provider Enrollment
Albuquerque, NM 87125-6666
Phone (505) 923-5356
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 83285733 | Medicaid | NM |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NM
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20040828000007 | NM | Practitioner - Emergency Medicine | 6709851298 | Reassigns benefits to 1 organization |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A-1264-04 | NM | MD | Emergency Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Presbyterian Healthcare Services | Emergency Medicine | Current | Accepting new patients |
| Presbyterian Healthcare Services | Current | Accepting new patients | |
| Monroe Emergency Physicians | Emergency Medicine | Past | Accepting new patients |
Locations
5901 Harper Dr NE
Albuquerque, NM 87109
Phone (505) 823-8233
3436 Isleta Blvd SW
Albuquerque, NM 87105
Phone (505) 462-7777
8300 Constitution Ave NE
Bldg D
Albuquerque, NM 87110
Phone (505) 291-2200
8300 Constitution Ave NE
Albuquerque, NM 87110
Phone (505) 291-2000
2200 W 21st St
Clovis, NM 88101
Phone (505) 769-7577
4801 Beckner Rd
Santa Fe, NM 87507
Phone (505) 772-1234
Interoperability endpoints
- dshafer30345@direct.phs.org
Organizations & group practices 3
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- General Acute Care Hospital
- Albuquerque, NM
- NPI 1215913470
Emergency Medicine
-
- Emergency Medicine Physician
- Monroe, MI
- NPI 1639103393
Emergency Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159920000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1219104000000",
"number": "1003901265",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 26666",
"address_2": "PHS PROVIDER ENROLLMENT",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "871256666",
"telephone_number": "505-923-5356",
"fax_number": "505-923-5354"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "PMG EMERGENCY MEDICINE",
"address_2": "1101 CENTRAL SE",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "87106",
"telephone_number": "505-841-1125",
"fax_number": "505-841-1737"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHAFER",
"first_name": "DARREN",
"middle_name": "M",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-04",
"last_updated": "2008-08-19",
"status": "A"
},
"taxonomies": [
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "NM",
"license": "A-1264-04",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "83285733",
"state": "NM"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Albuquerque, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.