Mathew Glen Krista, MD

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

21833 Issued in AL

Practice address

4126 West Main Street
Dothan, AL 36305-9310

Phone

(334) 793-2120

Fax

(334) 671-0228

NPI assigned

Apr 12, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 7

Electronic endpoints 2

Medicare fee-for-service enrollment

Enrolled in AL

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

Specialty

Emergency Medicine

Education

University of Alabama School of Medicine, 1995

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

FMG Primecare LLCGroup PAC ID 7012283864, 7 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Enhabit Home Health Home health agency, Dothan, AL, CCN 017053
• Flowers Hospital Hospital, Dothan, AL, CCN 010055

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mathew.krista.1@3326.direct.athenahealth.com
• Direct secure messaging: mathew.krista.2@3326.direct.athenahealth.com
• FHIR API: https://api.platform.athenahealth.com/3326/brand/1/csg/402/fhir/r4

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.

• FMG Primecare LLC

  • Family Medicine Physician
  • Dothan, AL
  • NPI 1427578228
  Medicare reassignment Care Compare group NPD
• Houston County Healthcare Authority

  • Internal Medicine Physician
  • Enterprise, AL
  • NPI 1619026606
  Medicare reassignment NPD
• Southern Alabama Physicians LLP

  • Emergency Medicine Physician
  • Dothan, AL
  • NPI 1467701490
  Medicare reassignment NPD
• Houston County Healthcare Authority

  • Internal Medicine Physician
  • Dothan, AL
  • NPI 1285783134

  Emergency Medicine

  NPD
• Houston County Healthcare Authority

  • Internal Medicine Physician
  • Dothan, AL
  • NPI 1538597349
  NPD
• Southern Alabama Physicians,LLP

  • Emergency Medicine Physician
  • Enterprise, AL
  • NPI 1649696378
  NPD
• Primecare of Dothan, PC

  • Primary Care Clinic/Center
  • Dothan, AL
  • NPI 1487726626
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Caresouth HHA Holdings of Dothan, LLC

  • Home Health Agency
  • Dothan, AL
  • NPI 1770561268
  Care Compare affiliation
• Triad of Alabama LLC

  • General Acute Care Hospital
  • Dothan, AL
  • NPI 1801830500
  Care Compare affiliation

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

{
    "created_epoch": "1144800000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600819200000",
    "number": "1093779738",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6599",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "363026599",
            "telephone_number": "334-793-2120",
            "fax_number": "334-671-0228"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4126 WEST MAIN STREET",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "363059310",
            "telephone_number": "334-793-2120",
            "fax_number": "334-671-0228"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRISTA",
        "first_name": "MATHEW",
        "middle_name": "GLEN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-12",
        "last_updated": "2020-09-23",
        "certification_date": "2020-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "KY",
            "license": "32247",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "AL",
            "license": "21833",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000799664B",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1756539",
            "state": "LA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC BS OF AL",
            "identifier": "51515842",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "06009894",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00055578",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "051515842",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "255415100",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mathew.krista.1@3326.direct.athenahealth.com",
            "affiliation": "N",
            "address_1": "4126 West Main Street",
            "city": "Dothan",
            "state": "AL",
            "country_code": "US",
            "postal_code": "363059310",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mathew.krista.1@3326.direct.athenahealth.com",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "4126 West Main Street",
            "city": "Dothan",
            "state": "AL",
            "country_code": "US",
            "postal_code": "363059310",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Kalen Kosik
• Sarina Kothari, DO
• Tadeus Edward Kowalski, M.D.
• Michael Kreger, M.D.
• Nithya Krishnakumaran, MD
• Alyssa Kronstadt-Trapasso, OTR/L
• Adam Joseph Krukas, PHARMD
• Frances Juanita Krumnow
• Sara Carroll Krystyn, CRNP
• Baylea Jade Kyle

• Emergency Medicine Physician in Dothan, AL
• Providers in Dothan, AL by specialty
• Emergency Medicine Physician in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2020; 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.

Verify at the official NPI Registry.