Matthew M Shortle, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

P65457 Issued in NY

Practice address

315 S Manning Blvd
@ St Peter's Hospital ER Dept.
Albany, NY 12208-1707

Phone

(518) 383-5450

Fax

(518) 383-4223

NPI assigned

Jul 7, 2008

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NY, FL2 enrollments

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 2

Merit-based Incentive Payment System (MIPS)

Final score

91.85 of 100Reported as group

Quality

79.23

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: mshortle788434@direct.trinity-health.org

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.

• Island Emergency Medical Services, P.C.

  • Emergency Medicine Physician
  • Far Rockaway, NY
  • NPI 1639160385
  Medicare reassignment
• Emergency Medicine Services of FL, LLC

  • Emergency Medicine Physician
  • Aventura, FL
  • NPI 1043917180
  Medicare reassignment
• Albany Emergency Medicine Associates, PC

  • Emergency Medicine Physician
  • Albany, NY
  • NPI 1235165374
  NPD (past)

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

{
    "created_epoch": "1215388800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697673600000",
    "number": "1235392663",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 768",
            "city": "CLIFTON PARK",
            "state": "NY",
            "postal_code": "120650768",
            "telephone_number": "518-383-5450",
            "fax_number": "518-383-4223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "315 S MANNING BLVD",
            "address_2": "@ ST PETER'S HOSPITAL ER DEPT.",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122081707",
            "telephone_number": "518-383-5450",
            "fax_number": "518-383-4223"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHORTLE",
        "first_name": "MATTHEW",
        "middle_name": "M",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-07-07",
        "last_updated": "2023-10-19",
        "certification_date": "2023-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9118121",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "P65457",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TEMP NYS LICENSE",
            "identifier": "P65457",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nikita Shoemaker
• Shoprite Supermarkets Inc (Shoprite Pharmacy of Colonie)
• Shoprite Supermarkets, Inc (Shoprite Pharmacy of Albany)
• Brenda Cynthia Shore, REGISTERED NURSE
• Amanda Elizabeth Shorey, MD
• Donna P Shoss
• Robert G Shoss, MD
• Nancy Shrestha, MD
• Robin Shufelt
• Aakash Kartik Shukla, PHARMD

• Physician Assistant in Albany, NY
• Providers in Albany, NY by specialty
• Physician Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 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.