Active NPI
Reena Mathew
- Family Nurse Practitioner
- Lewisville, TX
National Provider Identifier
1033550645
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 777243
- Practice address
- 314 W Main St
Lewisville, TX 75057-3866 - Phone
- (972) 316-2035
- Fax
- (972) 315-1507
- NPI assigned
- Jul 11, 2013
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 777243 | TX | Primary |
Addresses
Primary practice location
314 W Main St
Lewisville, TX 75057-3866
Mailing address
3806 Desert Willow Dr
Denton, TX 76208-7399
Phone (404) 451-4345
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2012
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
502 N Valley Pkwy
Suite 1
Lewisville, TX 75067-3437
Phone (972) 353-8616
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 777243 | TX | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Jalil a Khan, MD, PA | Current | Accepting new patients |
Locations
502 N Valley Pkwy
Ste 1
Lewisville, TX 75067
Phone (972) 353-8616
Interoperability endpoints
- https://fhir.meditouchehr.com/api/fhir/r4/
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1373500800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1373500800000",
"number": "1033550645",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3806 DESERT WILLOW DR",
"city": "DENTON",
"state": "TX",
"postal_code": "762087399",
"telephone_number": "404-451-4345"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "314 W MAIN ST",
"city": "LEWISVILLE",
"state": "TX",
"postal_code": "750573866",
"telephone_number": "972-316-2035",
"fax_number": "972-315-1507"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MATHEW",
"first_name": "REENA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2013-07-11",
"last_updated": "2013-07-11",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "TX",
"license": "777243",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lewisville, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.