Matthew Marvin Shankle, MD

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

License

4301053824 Issued in MI

Practice address

1101 W University
Rochester, MI 48307

Phone

(248) 652-5354

Fax

(248) 652-5407

NPI assigned

Jan 25, 2006

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 1

Medicare fee-for-service enrollment

Enrolled in MI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Anesthesiology

Education

Wayne State University School of Medicine, 1988

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Anesthesia Services Associates PCGroup PAC ID 4385557602, 67 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Ascension Providence Rochester Hospital Hospital, Rochester, MI, CCN 230254

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Interoperability endpoints

• Direct secure messaging: mshankle1150965@direct.hfhs.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.

• Anesthesia Services Associates, PC

  • Anesthesiology Physician
  • Lapeer, MI
  • NPI 1497797153
  Medicare reassignment Care Compare group

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Henry Ford Health Rochester Hospital

  • General Acute Care Hospital
  • Rochester, MI
  • NPI 1437176203
  Care Compare affiliation

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

{
    "created_epoch": "1138147200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1432080000000",
    "number": "1740250448",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "441 S LIVERNOIS",
            "address_2": "SUITE 190",
            "city": "ROCHESTER",
            "state": "MI",
            "postal_code": "483072591",
            "telephone_number": "248-656-9696",
            "fax_number": "248-656-5731"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 W UNIVERSITY",
            "city": "ROCHESTER",
            "state": "MI",
            "postal_code": "48307",
            "telephone_number": "248-652-5354",
            "fax_number": "248-652-5407"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHANKLE",
        "first_name": "MATTHEW",
        "middle_name": "MARVIN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-25",
        "last_updated": "2015-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "MI",
            "license": "4301053824",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "102903575",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kelly Scott, FNP
• Kimberly Enders Scott, MED, MA, LLP
• Honour Selent
• Mukesh S Shah, M.D
• Ava Marie Shamoon, PA-C
• Samantha M Shankle, CRNA
• Jeffrey Sharza
• Robert H Shaw, PHD
• Shelley R. Knowles, MD, PLLC
• Shen Dao, LLC

• Anesthesiology Physician in Rochester, MI
• Providers in Rochester, MI by specialty
• Anesthesiology Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2015; 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.