Individual provider Active NPI

Jacquie Lynn Mathai, PA-C

  • Physician Assistant
  • Boca Raton, FL
National Provider Identifier
1013492404
Registry record updated Dec 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9111498 Issued in FL
Practice address
370 Camino Gardens Blvd
Boca Raton, FL 33432-5816
Phone
(954) 456-4777
NPI assigned
Oct 1, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA9111498 FL Primary

Addresses

Primary practice location

370 Camino Gardens Blvd
Boca Raton, FL 33432-5816

Mailing address

8440 NW 24TH St
Sunrise, FL 33322-3318
Phone (954) 604-2203

Other practice location 1

10796 Pines Blvd
Pembroke Pines, FL 33026-3919
Phone (954) 885-5555

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200821001839 FL Practitioner - Physician Assistant 3779909601 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Natalia Hegedosh MD PAGroup PAC ID 3072771450, 5 clinicians

Practice addresses (Care Compare)

370 Camino Gardens Blvd
Suite 111
Boca Raton, FL 33432-5826
Phone (954) 456-4777

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA9111498FLMDPhysician Assistant

Interoperability endpoints

  • Direct secure messaging: jacquie.gonzalez.1@3342.direct.athenahealth.com

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1538352000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765411200000",
    "number": "1013492404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8440 NW 24TH ST",
            "city": "SUNRISE",
            "state": "FL",
            "postal_code": "333223318",
            "telephone_number": "954-604-2203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "370 CAMINO GARDENS BLVD",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334325816",
            "telephone_number": "954-456-4777"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10796 Pines Blvd",
            "address_purpose": "LOCATION",
            "city": "Pembroke Pines",
            "state": "FL",
            "postal_code": "330263919",
            "country_code": "US",
            "telephone_number": "954-885-5555",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MATHAI",
        "first_name": "JACQUIE",
        "middle_name": "LYNN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-10-01",
        "last_updated": "2025-12-11",
        "certification_date": "2025-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9111498",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boca Raton, FL

Sources for this page

Verify at the official NPI Registry.