Matthew D. Probst, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA2003-0043 Issued in NM

Practice address

2020 7TH St
Las Vegas, NM 87701-4958

Phone

(505) 434-0119

Fax

(877) 553-1272

NPI assigned

Aug 31, 2005

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

Other identifiers 2

Electronic endpoints 1

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, 2003

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Sunrise ClinicsGroup PAC ID 6800226374, 33 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Sunrise Clinics

  • Federally Qualified Health Center (FQHC)
  • Santa Rosa, NM
  • NPI 1164055927
  Medicare reassignment Care Compare group
• El Centro Family Health

  • Federally Qualified Health Center (FQHC)
  • Espanola, NM
  • NPI 1780689034
  Medicare reassignment NPD
• El Centro Family Health

  • Federally Qualified Health Center (FQHC)
  • Espanola, NM
  • NPI 1285899054
  NPD
• El Centro Family Health

  • Federally Qualified Health Center (FQHC)
  • Wagon Mound, NM
  • NPI 1538324223
  NPD (past)
• Sunrise Clinics

  • Student Health Clinic/Center
  • Las Vegas, NM
  • NPI 1194408625
  NPD (past)

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

{
    "created_epoch": "1125446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677110400000",
    "number": "1053305474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "117 CAMINO DE VIDA STE 300",
            "city": "SANTA ROSA",
            "state": "NM",
            "postal_code": "884352267",
            "telephone_number": "575-472-4311",
            "fax_number": "877-651-0289"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2020 7TH ST",
            "city": "LAS VEGAS",
            "state": "NM",
            "postal_code": "877014958",
            "telephone_number": "505-434-0119",
            "fax_number": "877-553-1272"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PROBST",
        "first_name": "MATTHEW",
        "middle_name": "D.",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-31",
        "last_updated": "2023-02-23",
        "certification_date": "2023-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NM",
            "license": "PA2003-0043",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "60950277",
            "state": "NM"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "NM400319",
            "state": "NM"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jessica.sanchez@sunrisnm.org",
            "affiliation": "N",
            "endpointDescription": "Credentialing",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "117 Camino De Vida Ste 300",
            "city": "Santa Rosa",
            "state": "NM",
            "country_code": "US",
            "postal_code": "884352267",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Quality Care, LLC.
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• Medical Physician Assistant in Las Vegas, NM
• Providers in Las Vegas, NM by specialty
• Medical Physician Assistant in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2023; 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.