MATTHEW SHANE EVANS CPO
NPI 1245476597
Prosthetist in Modesto, CA

Active since December 16, 2008
1705 COFFEE RD, SUITE 1, MODESTO, CA 95355(209) 544-2273(209) 544-2274 Get Directions Write a Review

NPPES record last updated: May 22, 2014. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Matthew Shane Evans Cpo NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MATTHEW SHANE EVANS CPO (NPI 1245476597) is an individual prosthetist provider in Modesto, California, licensed in California (CPO02042) and active in the NPI registry since December 2008.

NPPES Registry Identity

NPI1245476597
Entity TypeIndividualMale
Primary Taxonomy224P00000X
Provider Legal NameMATTHEW SHANE EVANSCredential: CPO
Location Address1705 COFFEE RD, SUITE 1Modesto, CA 95355-2809
Mailing Address1705 Coffee Rd, Suite1Modesto, CA 95355-2809 · (209) 544-2273 · Fax (209) 544-2274
Fax(209) 544-2274
Sole ProprietorYes
Enumeration DateDecember 16, 2008
Last NPPES UpdateMay 22, 2014
NPI 1245476597 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 4

Primary SpecialtyProsthetistRespiratory, Developmental, Rehabilitative and Restorative Service Providers
Taxonomy Code224P00000X
License Licensed in CA · CPO02042
Definition

A health care professional who is specifically educated and trained to manage comprehensive prosthetic patient care for individuals who have sustained complete or partial limb loss or absence. Prosthetists assess specific patient needs, formulate an appropriate treatment plan, implement the treatment plan and provide follow-up care.

Also ListedOrthotistTaxonomy 222Z00000X · License CPO02042 (CA)
Also ListedPedorthistTaxonomy 224L00000X · License CPO02042 (CA)
Also ListedProsthetic/Orthotic SupplierTaxonomy 335E00000X · License CPO02042 (CA)
1705 COFFEE RD, Modesto, CA 95355

Other Identifiers 2

MedicaidXC0020420CA
Medicare NSC6721560001CA

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Orthotic Fitter
1705 COFFEE RD, SUITE 3
MODESTO, CA 95355
Orthotic Fitter
1705 COFFEE RD, STE 3
MODESTO, CA 95355

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1245476597, enumerated as an "individual" on December 16, 2008.

The provider is located at 1705 COFFEE RD SUITE 1 MODESTO, CA 95355 and the phone number is (209) 544-2273.

Prosthetist with taxonomy code 224P00000X.

The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.