Mathew Shadiow, CRT, ARRT, CA FLUORO

Primary specialty

Radiologic TechnologistTaxonomy code 247100000X

License

RHF 74300 Issued in CA

Practice address

570 Willow Rd
Menlo Park, CA 94025-2617

Phone

(650) 324-8500

NPI assigned

Aug 18, 2008

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Access Radiology Techs

  • Portable X-ray and/or Other Portable Diagnostic Imaging Supplier
  • Menlo Park, CA
  • NPI 1447406772
  NPD (past) Authorized official

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

{
    "created_epoch": "1219017600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1219017600000",
    "number": "1467608794",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 612855",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951612855",
            "telephone_number": "408-829-2235"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "570 WILLOW RD",
            "city": "MENLO PARK",
            "state": "CA",
            "postal_code": "940252617",
            "telephone_number": "650-324-8500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHADIOW",
        "first_name": "MATHEW",
        "credential": "CRT, ARRT, CA FLUORO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-08-18",
        "last_updated": "2008-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "247100000X",
            "taxonomy_group": "",
            "desc": "Radiologic Technologist",
            "state": "CA",
            "license": "RHF 74300",
            "primary": true
        },
        {
            "code": "247100000X",
            "taxonomy_group": "",
            "desc": "Radiologic Technologist",
            "state": "MN",
            "license": "ARRT313398",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Dora Shalts-Lastra, MA

• Radiologic Technologist in Menlo Park, CA
• Providers in Menlo Park, CA by specialty
• Radiologic Technologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.