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SHELLY ANN MINISH PA-C
NPI 1477983849
Physician Assistant - Medical in Albuquerque, NM

Active since November 20, 2013PECOS Enrolled
610 BROADWAY BLVD NE, ALBUQUERQUE, NM 87102(505) 242-3991(505) 998-1660 Get Directions Write a Review

NPPES record last updated: March 7, 2023. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Mar 7, 2023, Jan 30, 2017 (2 updates tracked since 2017).

About Shelly Ann Minish Pa-c NPPES

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

SHELLY ANN MINISH PA-C (NPI 1477983849) is an individual medical provider in Albuquerque, New Mexico, licensed in New Mexico (PA2016-0106) and active in the NPI registry since November 2013. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1477983849
Entity TypeIndividualFemale
Primary Taxonomy363AM0700X
Provider Legal NameSHELLY ANN MINISHCredential: PA-C
Location Address610 BROADWAY BLVD NEAlbuquerque, NM 87102-2372
Mailing Address610 Broadway Blvd NeAlbuquerque, NM 87102-2372 · (505) 242-3991 · Fax (505) 998-1660
Phone(505) 242-3991
Fax(505) 998-1660
Sole ProprietorNo
Enumeration DateNovember 20, 2013
Last NPPES UpdateMarch 7, 20232 updates tracked since enumeration
✔ NPI 1477983849 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPhysician Assistant · MedicalPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363AM0700X
License✔ Licensed in NM · PA2016-0106
Also ListedPhysician AssistantTaxonomy 363A00000X · License PA2016-0106 (NM)
610 BROADWAY BLVD NE, Albuquerque, NM 87102
Open in Google Maps ↗

Other Identifiers 1

OtherPA2016-0106NM · Nm Medical License

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Shelly Ann Minish Pa-c is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 15

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

DERMATOLOGY OF NEW MEXICO LLC
Clinic/Center
610 BROADWAY BLVD NE
ALBUQUERQUE, NM 87102
Bernalillo County (505) 225-2500
DR. PETER ABRAHAM HEADLEY M.D.
Urology
610 BROADWAY BLVD NE
ALBUQUERQUE, NM 87102
Bernalillo County (505) 242-3991
DR. VAUN TAYLOR FLOYD JR. M.D.
Urology
610 BROADWAY BLVD NE
ALBUQUERQUE, NM 87102
Bernalillo County (505) 242-3991
DEITRA GATES CNS
Clinical Nurse Specialist (Adult Health)
610 BROADWAY BLVD NE
ALBUQUERQUE, NM 87102
Bernalillo County (505) 242-3991
ALBUQUERQUE UROLOGY ASSOCIATES, PA
Urology
610 BROADWAY BLVD NE
ALBUQUERQUE, NM 87102
Bernalillo County (505) 242-3991
BRADLEY WALTERS PAC
Physician Assistant
610 BROADWAY BLVD NE
ALBUQUERQUE, NM 87102
Bernalillo County (505) 225-2500
DR. STEFAN H. GUTOW M.D.
Specialist
610 BROADWAY BLVD NE
ALBUQUERQUE, NM 87102
Bernalillo County (505) 242-3991
JAMIE F EDENS PA-C
Physician Assistant (Medical)
610 BROADWAY BLVD NE
ALBUQUERQUE, NM 87102
Bernalillo County (505) 242-3991

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Shelly Minish's NPI number?

The NPI number for Shelly Minish is 1477983849. It was assigned to this individual provider in the NPPES registry on November 20, 2013.

Where is Shelly Minish located?

Shelly Minish practices at 610 Broadway Blvd NE, Albuquerque, NM 87102. The listed phone number is (505) 242-3991.

What is Shelly Minish's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Medical, with taxonomy code 363AM0700X.

Is Shelly Minish enrolled in Medicare?

Yes. Shelly Minish is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Shelly Minish was last updated on March 7, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.