Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Matthew Stephen Shute, PA

Individual provider Physician Assistant · NPI 1639198526

Matthew Stephen Shute, PA is a Physician Assistant in Fayetteville, New York. Qualified in 2005, 21 years ago. Practices with St Josephs Medical PC, a 385-clinician group, accepts Medicare assignment and offers telehealth. Licensed in New York.

Years since qualifying
21
Licensed in
NY
In the registry since
2006
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

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Practice location Address checks out

4000 Medical Center Dr Ste 104
Fayetteville, NY 13066-6635
Phone: (315) 663-0059
Fax: (315) 663-0123
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 011106 (NY)

Record details

NPI number1639198526
Entity typeIndividual (Type 1)
GenderMale
Credentials PA
Sole proprietorNo
NPI enumeratedJuly 19, 2006
Last updated in NPPESMay 8, 2023
Certification dateMay 8, 2023
Mailing address5112 West Taft Road, Suite L, Liverpool, NY 13088

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2005 (21 years in practice)
Group practice St Josephs Medical Pc — 385 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations5 on file with Medicare

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