Provider Demographics
NPI:1205842804
Name:SCHIERENBERG, MATTHEW STEPHEN (CAA)
Entity Type:Individual
Prefix:MR
First Name:MATTHEW
Middle Name:STEPHEN
Last Name:SCHIERENBERG
Suffix:
Gender:M
Credentials:CAA
Other - Prefix:MR
Other - First Name:MATT
Other - Middle Name:
Other - Last Name:SCHIERENBERG
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 840862
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75284-0862
Mailing Address - Country:US
Mailing Address - Phone:303-377-7638
Mailing Address - Fax:303-780-0787
Practice Address - Street 1:8000 E MAPLEWOOD AVE STE 120
Practice Address - Street 2:
Practice Address - City:GREENWOOD VILLAGE
Practice Address - State:CO
Practice Address - Zip Code:80111-4766
Practice Address - Country:US
Practice Address - Phone:303-438-3999
Practice Address - Fax:720-439-9500
Is Sole Proprietor?:No
Enumeration Date:2006-08-01
Last Update Date:2023-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COANT.0000007367H00000X, 367H00000X
NMAA2003-0003207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367H00000XPhysician Assistants & Advanced Practice Nursing ProvidersAnesthesiologist Assistant
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA580628385OtherTRICARE
GA637887346FMedicaid
GAN537829OtherWELLCARE
GAP00877459OtherRAILROAD MEDICARE
GAN537829OtherWELLCARE