Active NPI
Susan Mathai
- Pharmacist
- Aurora, CO
National Provider Identifier
1104101609
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PHA19278
- Practice address
- 16601 E Centretech Pkwy
Aurora, CO 80011-9045 - Phone
- (303) 338-4545
- NPI assigned
- Oct 15, 2011
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | PS47017 | FL | |
| Pharmacist | 183500000X | PHA19278 | CO | Primary |
Addresses
Primary practice location
16601 E Centretech Pkwy
Aurora, CO 80011-9045
Mailing address
16601 E Centretech Pkwy
Aurora, CO 80011-9045
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PHA19278 | CO | MD | Pharmacist |
| PS47017 | FL | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1318636800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1571875200000",
"number": "1104101609",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "16601 E CENTRETECH PKWY",
"city": "AURORA",
"state": "CO",
"postal_code": "800119045"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "16601 E CENTRETECH PKWY",
"city": "AURORA",
"state": "CO",
"postal_code": "800119045",
"telephone_number": "303-338-4545"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MATHAI",
"first_name": "SUSAN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-10-15",
"last_updated": "2019-10-24",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "FL",
"license": "PS47017",
"primary": false
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CO",
"license": "PHA19278",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Aurora, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.