Patrick Keenan Shanley, PA-C

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

PA2008-0045 Issued in NM

Practice address

1219 Gusdorf Rd Ste a
Taos, NM 87571-6499

Phone

(505) 758-0009

Fax

(505) 758-8736

NPI assigned

May 14, 2008

Last updated

Jun 17, 2016By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Presbyterian Healthcare ServicesGroup PAC ID 9234041708, 1,390 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Presbyterian Espanola Hospital Hospital, Espanola, NM, CCN 320011
• Christus St Vincent Regional Medical Center Hospital, Santa Fe, NM, CCN 320002

Merit-based Incentive Payment System (MIPS)

Final score

88.68 of 100Reported as group

Quality

82.35

Promoting interoperability

100

Improvement activities

40

Cost

76.6

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: pshanley171610@direct.phs.org

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Presbyterian Healthcare Services

  dba Presbyterian Medical Group

  • Internal Medicine Physician
  • Albuquerque, NM
  • NPI 1104802354
  Medicare reassignment Care Compare group NPD
• Presbyterian Healthcare Services

  dba Presbyterian Hospital

  • General Acute Care Hospital
  • Albuquerque, NM
  • NPI 1215913470
  NPD
• Presbyterian Healthcare Services

  dba Espanola Hospital

  • Rural Acute Care Hospital
  • Espanola, NM
  • NPI 1154307593
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Presbyterian Healthcare Services

  dba Espanola Hospital

  • Rural Acute Care Hospital
  • Espanola, NM
  • NPI 1154307593
  Care Compare affiliation
• St Vincent Hospital

  dba CHRISTUS St. Vincent Regional Medical Center

  • General Acute Care Hospital
  • Santa Fe, NM
  • NPI 1578587150
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1210723200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1466121600000",
    "number": "1033386420",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1397 WEIMER RD",
            "city": "TAOS",
            "state": "NM",
            "postal_code": "875716253",
            "telephone_number": "505-758-0009",
            "fax_number": "505-758-8736"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1219 GUSDORF RD STE A",
            "city": "TAOS",
            "state": "NM",
            "postal_code": "875716499",
            "telephone_number": "505-758-0009",
            "fax_number": "505-758-8736"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHANLEY",
        "first_name": "PATRICK",
        "middle_name": "KEENAN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-05-14",
        "last_updated": "2016-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NM",
            "license": "PA2008-0045",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• SG Flourishes, Inc.
• Shadow Mountain LLC. (Shadow Mountain Recovery, Taos)
• Joshua Shaffer
• Kishan Mitesh Shah, MD
• Catherine Shank
• Santee N. Shanta, CASE MANAGER
• Raymond Anthony Shelko, D.D.S.
• Barbara Sherman, MA, LMFT
• Josephine E Shije, R.N.
• Stephanie Michelle Short, LMT

• Surgical Physician Assistant in Taos, NM
• Providers in Taos, NM by specialty
• Surgical Physician Assistant in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2016; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.