| Shane Martin Wible, MPAS, PA-C | |
|
60 Merritt Blvd, Suite 106, Fishkill, NY 12524-2990 | |
| (845) 905-5090 | |
| Not Available |
| Full Name | Shane Martin Wible |
|---|---|
| Gender | Male |
| Speciality | Physician Assistant |
| Experience | 19 Years |
| Location | 60 Merritt Blvd, Fishkill, New York |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013199330 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363A00000X | Physician Assistant | 6792106-1206 (Utah) | Primary |
| 363A00000X | Physician Assistant | PA2013-0029 (New Mexico) | Secondary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Ellenville Regional Hospital | Ellenville, NY | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Ellenville Emergency Medical Associates Pllc | 9436478658 | 8 |
| Entity Name | Nes Medical Services of New York PC |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1215455191 PECOS PAC ID: 0840181392 Enrollment ID: O20040323001392 |
| Entity Name | Ellenville Emergency Medical Associates PLLC |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1477945905 PECOS PAC ID: 9436478658 Enrollment ID: O20150508001689 |
| Mailing Address | Practice Location Address |
|---|---|
| Shane Martin Wible, MPAS, PA-C 582 E Browning Ave, Salt Lake City, UT 84105-2025 Ph: (650) 619-8618 | Shane Martin Wible, MPAS, PA-C 60 Merritt Blvd, Suite 106, Fishkill, NY 12524-2990 Ph: (845) 905-5090 |
Ms. Carolyn Baker, Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 969 Main St Ste D, Fishkill, NY 12524 Phone: 845-896-7730 Fax: 845-896-7758 |
Melissa Ashley Moustakas, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 60 Merritt Blvd, Fishkill, NY 12524 Phone: 845-765-4990 |
Courtney Emerson, PA Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 969 Main St Ste D, Fishkill, NY 12524 Phone: 845-896-7730 Fax: 845-896-7758 |
Scott Markumas, PA Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 400 Westage Business Ctr Dr, Suite 210, Fishkill, NY 12524 Phone: 845-838-8480 Fax: 845-838-8474 |
Olga Gaskins, Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 969 Main St Ste D, Fishkill, NY 12524 Phone: 845-896-7730 Fax: 845-896-7758 |
Russell M. Higley, P.A. Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 200 Westage Business Center Drive, Suite 224, Fishkill, NY 12524 Phone: 845-896-9200 Fax: 845-896-3262 |
Alicia Beardsley, PA Physician Assistant Medicare: Medicare Enrolled Practice Location: 600 Westage Business Ctr Dr, Fishkill, NY 12524 Phone: 845-231-5600 Fax: 845-231-5670 |