Matthew Alan Shadis | Santa Fe, NM • PECOS Search

Matthew Alan Shadis

Case Manager/Care Coordinator

Other Service Providers

2325 Cerrillos Rd, Santa Fe, NM 87505-3373

(505) 438-0010 (505) 438-8488

PECOS Enrollment

Based on the most recent information from CMS, provider Matthew Alan Shadis does not have current enrollment records in PECOS.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Not Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records yesterday at 9:43 AM.

Profile Details

Provider ID
1275811739
Provider Type
Individual
Full Name
Shadis, Matthew Alan
Title
Mr.

Gender
Male
Sole Proprietor
Yes
Enumeration Date
8/1/2011
Last Updated
8/1/2011

Contact Information

Practice Location

2325 Cerrillos Rd, Santa Fe, NM 87505-3373

(505) 438-6011

Mailing Location

2325 Cerrillos Road, Santa Fe, NM 87505

(505) 438-6011

Provider Taxonomies

Code	Description	License
Code 171M00000X Primary	Description Case Manager/Care Coordinator Other Service Providers	License Unlisted Issuer