MATTHEW SHANE EVANS CPO NPI 1245476597

NPI Information

  • NPI: 1245476597
  • Provider Name: MATTHEW SHANE EVANS, CPO
  • Classification: Prosthetist - 224P00000X
  • Entity Type: Individual
  • Address: 1705 COFFEE RD
    SUITE 1
    MODESTO, CA
    ZIP 95355
  • Phone: (209) 544-2273

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NPI Details

Matthew Shane Evans, CPO is a prosthetist in Modesto, CA. The provider is 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. Matthew Shane Evans, CPO NPI is 1245476597. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

1705 COFFEE RD
SUITE 1
MODESTO, CA
ZIP 95355-809
Phone: (209) 544-2273
Fax: (209) 544-2274

The enumeration date for this NPI number is 12/16/2008 and was last updated on 5/22/2014.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1222Z00000XOrthotistCPO02042CALIFORNIANo
2224L00000XPedorthistCPO02042CALIFORNIANo
3335E00000XProsthetic/Orthotic SupplierCPO02042CALIFORNIANo
4224P00000XProsthetistCPO02042CALIFORNIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1XC0020420MEDICAIDCALIFORNIA
26721560001MEDICARE NSCCALIFORNIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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