Individual provider Active NPI

Brittany Mathias, PA

  • Physician Assistant
  • Englewood, OH
National Provider Identifier
1073983342
Registry record updated Sep 30, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
50.004454 Issued in OH
Practice address
9000 N Main St
Suite 232
Englewood, OH 45415-1180
Phone
(937) 277-8988
Fax
(937) 274-4293
NPI assigned
Sep 30, 2015
Last updated
Sep 30, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2015

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 50.004454 OH Primary

Addresses

Primary practice location

9000 N Main St
Suite 232
Englewood, OH 45415-1180

Mailing address

9000 N Main St
Suite 232
Englewood, OH 45415-1180
Phone (937) 277-8988

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20151015002547 OH Practitioner - Physician Assistant 5698084523 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
50.004454OHMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Premier Health Specialists Inc Physician Assistant CurrentSince Oct 1, 2015 Accepting new patients
Premier Health Specialists Inc CurrentSince Oct 1, 2015 Accepting new patients

Locations

30 E Apple St
#6258
Dayton, OH 45409
Phone (937) 208-5300

9000 N Main St
Ste 232
Englewood, OH 45415
Phone (937) 274-5420

3170 Kettering Blvd
Bldg 3
Moraine, OH 45439

450 N Hyatt St
Ste 304
Tipp City, OH 45371
Phone (937) 832-4773

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": "1443571200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1443571200000",
    "number": "1073983342",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9000 N MAIN ST",
            "address_2": "SUITE 232",
            "city": "ENGLEWOOD",
            "state": "OH",
            "postal_code": "454151180",
            "telephone_number": "937-277-8988",
            "fax_number": "937-274-4293"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9000 N MAIN ST",
            "address_2": "SUITE 232",
            "city": "ENGLEWOOD",
            "state": "OH",
            "postal_code": "454151180",
            "telephone_number": "937-277-8988",
            "fax_number": "937-274-4293"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATHIAS",
        "first_name": "BRITTANY",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-09-30",
        "last_updated": "2015-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OH",
            "license": "50.004454",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Englewood, OH

Sources for this page

Verify at the official NPI Registry.