Individual provider Active NPI

Vinci Mathew

  • Physician Assistant
  • Hempstead, NY
National Provider Identifier
1073149811
Registry record updated Jun 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
024821 Issued in NY
Practice address
540 Fulton Ave
Hempstead, NY 11550-4364
Phone
(516) 750-2500
NPI assigned
Mar 12, 2020
Last updated
Jun 24, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2023

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 024821 NY Primary

Addresses

Primary practice location

540 Fulton Ave
Hempstead, NY 11550-4364

Mailing address

540 Fulton Ave
Hempstead, NY 11550-4364

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220201000820 NY Practitioner - Physician Assistant 3971996653 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
State University of New York Downstate Medical Center, 2019
Medicare assignment
May accept Medicare assignment
Group practices
Planned Parenthood of Greater New York IncGroup PAC ID 7810293297, 34 clinicians

Practice addresses (Care Compare)

2141 45TH Rd
Long Island City, NY 11101-4706
Phone (516) 750-2500

540 Fulton Ave
Hempstead, NY 11550-4364
Phone (516) 750-2500

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
024821NYMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Planned Parenthood of the Southern Finger Lakes Inc. Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: vmatthew555910@nychhc.direct-ci.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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1583971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687564800000",
    "number": "1073149811",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "540 FULTON AVE",
            "city": "HEMPSTEAD",
            "state": "NY",
            "postal_code": "115504364"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "540 FULTON AVE",
            "city": "HEMPSTEAD",
            "state": "NY",
            "postal_code": "115504364",
            "telephone_number": "516-750-2500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATHEW",
        "first_name": "VINCI",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-03-12",
        "last_updated": "2023-06-24",
        "certification_date": "2023-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "024821",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hempstead, NY

Sources for this page

Verify at the official NPI Registry.