Individual provider Active NPI

Merlyn Mathew, D.O.

  • Endocrinology, Diabetes & Metabolism Physician
  • Lawrence, NY
National Provider Identifier
1033564596
Registry record updated Nov 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
License
309674-01 Issued in NY
Practice address
290 Central Ave Ste 202
Lawrence, NY 11559-8507
Phone
(516) 371-0517
NPI assigned
May 3, 2016
Last updated
Nov 4, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endocrinology, Diabetes & Metabolism Physician 207RE0101X 309674-01 NY Primary

Addresses

Primary practice location

290 Central Ave Ste 202
Lawrence, NY 11559-8507

Mailing address

290 Central Ave Ste 202
Lawrence, NY 11559-8507

Other practice location 1

2601 Ocean Pkwy
Brooklyn, NY 11235-7745
Phone (718) 616-3000

Other identifiers 1

IdentifierTypeStateIssuer
FR97383UMedicaidNY

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mmathew26@nslijgr.allscriptsdirect.net

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211011002665 NY Practitioner - Endocrinology 4587062294 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Endocrinology
Education
New York College of Osteo Medicine of New York Institute of Technology, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
North Shore-Lij Medical PCGroup PAC ID 3375701568, 6,374 clinicians

Practice addresses (Care Compare)

290 Central Ave
Suite 202
Lawrence, NY 11559-8507
Phone (516) 371-0517

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
93.07 of 100Reported as apm
Quality
79.77
Promoting interoperability
88.77
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
309674-01NYMDEndocrinology, Diabetes & Metabolism Physician

Practice roles

OrganizationSpecialtyStatusNew patients
North Shore-Lij Medical PC CurrentSince Oct 4, 2021 Accepting new patients
Irene Zide MD Endocrinology, Diabetes & Metabolism PastSince Jun 15, 2021 Accepting new patients

Locations

290 Central Ave
Ste 202
Lawrence, NY 11559
Phone (516) 371-0517

300 Community Dr
Manhasset, NY 11030

972 Brush Hollow Rd
Westbury, NY 11590

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359

Interoperability endpoints

  • Direct secure messaging: merlynmathew@nslijmedgr.allscriptsdirect.net

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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": "1462233600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667520000000",
    "number": "1033564596",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "290 CENTRAL AVE STE 202",
            "city": "LAWRENCE",
            "state": "NY",
            "postal_code": "115598507"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "290 CENTRAL AVE STE 202",
            "city": "LAWRENCE",
            "state": "NY",
            "postal_code": "115598507",
            "telephone_number": "516-371-0517"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2601 Ocean Pkwy",
            "address_purpose": "LOCATION",
            "city": "Brooklyn",
            "state": "NY",
            "postal_code": "112357745",
            "country_code": "US",
            "telephone_number": "718-616-3000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MATHEW",
        "first_name": "MERLYN",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-05-03",
        "last_updated": "2022-11-04",
        "certification_date": "2022-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "NY",
            "license": "309674-01",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "FR97383U",
            "state": "NY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mmathew26@nslijgr.allscriptsdirect.net",
            "affiliation": "N",
            "address_1": "290 Central Ave Ste 202",
            "city": "Lawrence",
            "state": "NY",
            "country_code": "US",
            "postal_code": "115598507",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Lawrence, NY

Sources for this page

Verify at the official NPI Registry.