Active NPI
Philip T Shields, MD
- Neurological Surgery Physician
- Santa Fe, NM
National Provider Identifier
1164516555
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neurological Surgery Physician
- License
- 200199
- Practice address
- 465 Saint Michaels Dr
Suite 107
Santa Fe, NM 87505-7670 - Phone
- (505) 988-3233
- NPI assigned
- Oct 3, 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 |
|---|---|---|---|---|
| Neurological Surgery Physician | 207T00000X | 200199 | NM | Primary |
Addresses
Primary practice location
465 Saint Michaels Dr
Suite 107
Santa Fe, NM 87505-7670
Mailing address
465 Saint Michaels Dr
Suite 107
Santa Fe, NM 87505-7670
Phone (505) 988-3233
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000N4748 | 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 |
|---|---|---|---|---|
| I20240726002653 | NM | Practitioner - Neurosurgery | 0143270678 | Reassigns benefits to 1 organization |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 200199 | NM | MD | Neurological Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Presbyterian Healthcare Services | Neurological Surgery | Current | Accepting new patients |
| Presbyterian Healthcare Services | Current | Accepting new patients |
Locations
2200 W 21st St
Clovis, NM 88101
Phone (505) 769-7577
531 Harkle Rd
Ste D
Santa Fe, NM 87505
Phone (505) 982-4200
Interoperability endpoints
- pshields164699@christushealth.direct-ci.net
Organizations & group practices 2
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.
-
- Internal Medicine Physician
- Albuquerque, NM
- NPI 1104802354
Neurological Surgery, NM
-
- General Acute Care Hospital
- Albuquerque, NM
- NPI 1215913470
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159833600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1330041600000",
"number": "1164516555",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "465 SAINT MICHAELS DR",
"address_2": "SUITE 107",
"city": "SANTA FE",
"state": "NM",
"postal_code": "875057670",
"telephone_number": "505-988-3233"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "465 SAINT MICHAELS DR",
"address_2": "SUITE 107",
"city": "SANTA FE",
"state": "NM",
"postal_code": "875057670",
"telephone_number": "505-988-3233"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHIELDS",
"first_name": "PHILIP",
"middle_name": "T",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-03",
"last_updated": "2012-02-24",
"status": "A"
},
"taxonomies": [
{
"code": "207T00000X",
"taxonomy_group": "",
"desc": "Neurological Surgery",
"state": "NM",
"license": "200199",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "000N4748",
"state": "NM"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Santa Fe, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2012; 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.