Bibby P Mathew, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

20994 Issued in TX

Practice address

1221 W Ben White Blvd
Suite 112B
Austin, TX 78704-7192

Phone

(512) 978-9700

Fax

(512) 279-2307

NPI assigned

Jun 10, 2006

Last updated

Apr 12, 2017By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Central Texas Community Health Centers

  • Federally Qualified Health Center (FQHC)
  • Austin, TX
  • NPI 1073820023
  NPD (past)
• Central Texas Community Health Centers

  dba CommUnityCare

  • Federally Qualified Health Center (FQHC)
  • Austin, TX
  • NPI 1598591414
  NPD (past)

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

{
    "created_epoch": "1149897600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1491955200000",
    "number": "1053352781",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1221 W BEN WHITE BLVD",
            "address_2": "SUITE 112B",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787047192",
            "telephone_number": "512-978-9700",
            "fax_number": "512-279-2307"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1221 W BEN WHITE BLVD",
            "address_2": "SUITE 112B",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787047192",
            "telephone_number": "512-978-9700",
            "fax_number": "512-279-2307"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATHEW",
        "first_name": "BIBBY",
        "middle_name": "P",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-10",
        "last_updated": "2017-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "20994",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "431823399",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kim Lauren Matejowsky, LCSW
• Michelle Materna
• Kelly Haywood Mathabela, LCSW
• Heather Matheson, RN
• Angela Mabel Mathew, DDS
• Hanna Mathew
• Nancy Ann Mathew, DO
• Natasha Maria Mathew, DDS
• Sherin Ann Mathew, OD
• Susanne Mathew, MD

• General Practice Dentistry in Austin, TX
• Providers in Austin, TX by specialty
• General Practice Dentistry in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2017; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.