Matthew Patrick Shannon, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

6866 Issued in AZ

Practice address

2680 S Val Vista Dr Ste 116
Gilbert, AZ 85295-2154

Phone

(480) 507-5678

Fax

(480) 507-5677

NPI assigned

Sep 20, 2017

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

Medicare fee-for-service enrollment

Enrolled in AZ

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 1

Specialty

Physician Assistant

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Banner Physician Specialists Arizona LLCGroup PAC ID 6204002272, 371 clinicians

VHS Outpatient Clinics IncGroup PAC ID 4486566726, 206 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Banner Desert Medical Center Hospital, Mesa, AZ, CCN 030065

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Banner Physician Specialists Arizona LLC

  • Multi-Specialty Clinic/Center
  • Phoenix, AZ
  • NPI 1821368218
  Medicare reassignment Care Compare group NPD
• VHS Outpatient Clinics, Inc.

  • Multi-Specialty Clinic/Center
  • Goodyear, AZ
  • NPI 1912979964
  Medicare reassignment Care Compare group NPD
• Arizona Centers for Digestive Health LLC

  • Gastroenterology Physician
  • Gilbert, AZ
  • NPI 1568975316
  Medicare reassignment
• Arizona Gastrointestinal Associates, PLC

  • Gastroenterology Physician
  • Phoenix, AZ
  • NPI 1356609002
  Medicare reassignment
• Banner Physician Specialists Arizona LLC

  • Multi-Specialty Clinic/Center
  • Phoenix, AZ
  • NPI 1316228802
  NPD
• Banner Physician Specialists Arizona LLC

  • Multi-Specialty Clinic/Center
  • Page, AZ
  • NPI 1366799355
  NPD

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

• Banner Desert Medical Center

  • General Acute Care Hospital
  • Mesa, AZ
  • NPI 1720011810
  Care Compare affiliation

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

{
    "created_epoch": "1505865600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1505865600000",
    "number": "1851800049",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1356 W 14TH ST",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "852816407",
            "telephone_number": "602-505-2894"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2680 S VAL VISTA DR STE 116",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852952154",
            "telephone_number": "480-507-5678",
            "fax_number": "480-507-5677"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHANNON",
        "first_name": "MATTHEW",
        "middle_name": "PATRICK",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-09-20",
        "last_updated": "2017-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "6866",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ayesha Shaikh, MD
• Daanish Khalid Shaikh, M.D.
• Mohammad Shaikh
• Kelli Shallal, RD
• Amy Shannon-McConaughy, PA-C
• Juliet Sharley, M.S. OTR/L CHT
• Anoop K Sharma, MD
• Diksha Sharma
• Neil R Sharma, M.D.
• Ronica S Sharma, OD

• Physician Assistant in Gilbert, AZ
• Providers in Gilbert, AZ by specialty
• Physician Assistant in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2017; 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.