Matthew John Charles, D.O.
Individual provider Active NPI Anesthesiology Physician · Albuquerque, NM
NPI 1255504684 · NPPES record last updated Apr 12, 2013
Key facts
- NPI
- 1255504684
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Anesthesiology Physician 207L00000X
- License
- A-1672-12 (NM)
- Practice address
- Unm Hospital
2211 Lomas Blvd NE
Albuquerque, NM 87131-0001 - Phone
- (505) 272-2111
- Fax
- (505) 272-1300
- NPI assigned
- Apr 7, 2008
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 10
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Anesthesiology
- Education
- Other, 2008
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- St Vincent Hospital
Practice addresses (Care Compare)
2990 Rodeo Park Dr E
Santa Fe, NM 87505-6302
Phone (505) 913-8900
433 Saint Michaels Dr
Santa Fe, NM 87505-7601
Phone (505) 988-1232
445 Saint Michaels Dr
Santa Fe, NM 87505-7601
Phone (505) 913-8900
455 Saint Michaels Dr
Santa Fe, NM 87505-7601
Hospital & facility affiliations
- Christus St Vincent Regional Medical Center
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NM
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20120830000702 | NM | Practitioner - Anesthesiology | 1456508191 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Osteopathy
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| St. Vincent Hospital | Current |
Accepting new patients | |
| St Vincent Hospital | Anesthesiology | Current |
Accepting new patients |
| St Vincent Hospital | Current | Accepting new patients |
Locations
455 Saint Michaels Dr
Santa Fe, NM 87505
Phone (505) 913-3361
2211 Lomas Blvd NE
Unm, NM 87106
Phone (505) 272-1111
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Anesthesiology Physician | 207L00000X | A-1672-12 | NM | Yes |
Addresses
Primary practice location
Unm Hospital
2211 Lomas Blvd NE
Albuquerque, NM 87131-0001
Mailing address
Unm Hospital
2211 Lomas Blvd NE
Albuquerque, NM 87131-0001
Phone (505) 272-2610
NPI Registry JSON
{
"created_epoch": "1207526400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1365724800000",
"number": "1255504684",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "UNM HOSPITAL",
"address_2": "2211 LOMAS BLVD NE",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "871310001",
"telephone_number": "505-272-2610",
"fax_number": "505-272-1300"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "UNM HOSPITAL",
"address_2": "2211 LOMAS BLVD NE",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "871310001",
"telephone_number": "505-272-2111",
"fax_number": "505-272-1300"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHARLES",
"first_name": "MATTHEW",
"middle_name": "JOHN",
"credential": "D.O.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-04-07",
"last_updated": "2013-04-12",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "NM",
"license": "A-1672-12",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Albuquerque, NM
- Johanna Chappelle
- Charest Counseling and Consulting, LLC
- Kathleen Charest
- Krishna Chari
- Charitin Family Care Services LLC
- Sarah I Charles
- Cheryl L Charley
- Gwenn H. Charley
- Sha Charley
- Sheila Charley
All providers in Albuquerque, NM · Anesthesiology Physician in New Mexico
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 12, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.