Individual provider Active NPI

Mathew George Mathai, M.D.

  • Pulmonary Disease Physician
  • Cudahy, WI
National Provider Identifier
1104854363
Registry record updated Dec 5, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
45983 Issued in WI
Practice address
5900 S. Lake Dr.
Cudahy, WI 53110
Phone
(414) 744-4000
Fax
(414) 489-4022
NPI assigned
Jun 28, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 5, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pulmonary Disease Physician 207RP1001X 45983 WI Primary

Addresses

Primary practice location

5900 S. Lake Dr.
Cudahy, WI 53110

Mailing address

5900 S. Lake Dr.
Cudahy, WI 53110
Phone (414) 744-4000

Other identifiers 1

IdentifierTypeStateIssuer
34650600MedicaidWI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
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

Enrollment IDStateProvider typePAC IDDetails
I20040629000787 WI Practitioner - Pulmonary DiseasePractitioner - Internal Medicine 4284610247 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pulmonary DiseaseAlso: Internal Medicine
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Ascension Medical Group-Southeast Wisconsin IncGroup PAC ID 8628980943, 551 clinicians
Watertown Physician Practices LLCGroup PAC ID 8022329408, 64 clinicians
Pulmonary and Critical Care Associates S CGroup PAC ID 4183695737, 7 clinicians

Practice addresses (Care Compare)

10101 S 27TH St
Franklin, WI 53132-7209
Phone (414) 325-4700

125 Hospital Dr
Watertown, WI 53098-3303
Phone (920) 262-4449

13950 W Capitol Dr
Brookfield, WI 53005-2441
Phone (414) 302-5400

201 N Mayfair Rd
Wauwatosa, WI 53226-4216

3237 S 16TH St
Milwaukee, WI 53215-4526
Phone (414) 647-5069

3801 Spring St
Mount Pleasant, WI 53405-1667
Phone (262) 687-4011

3803 Spring St
Mount Pleasant, WI 53405-1660

3807 Spring St
Mount Pleasant, WI 53405-1667
Phone (262) 687-8300

3809 Spring St
Mount Pleasant, WI 53405-1667
Phone (262) 687-5000

3811 Spring St
Mount Pleasant, WI 53405-1667

3821 Spring St
Mount Pleasant, WI 53405-1667
Phone (262) 687-8460

5900 S Lake Dr
Cudahy, WI 53110-3171
Phone (414) 744-4000

9969 S 27TH St
Franklin, WI 53132-9533
Phone (414) 325-4940

Hospital & facility affiliations

  • Watertown Memorial Hospital Hospital, Watertown, WI, CCN 520116
  • Ascension All Saints Hospital Hospital, Racine, WI, CCN 520096
  • Ascension SE Wisconsin Hospital Hospital, Milwaukee, WI, CCN 520136
  • Aurora St Lukes Medical Center Hospital, Milwaukee, WI, CCN 520138
  • Ascension St Francis Hospital Hospital, Milwaukee, WI, CCN 520078

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
45983WIMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Aurora Medical Group, Inc. CurrentSince Mar 1, 2006 Accepting new patients
Ascension Medical Group-Southeast Wisconsin Inc CurrentSince Feb 9, 2012 Accepting new patients
Watertown Physician Practices LLC Current Accepting new patients
Watertown Physician Practices LLC Pulmonary Disease CurrentSince Jan 2, 2017 Accepting new patients
Pulmonary & Critical Care Associates S C CurrentSince Jan 1, 2004 Accepting new patients
Aurora Medical Group, Inc. CurrentSince Mar 1, 2006 Accepting new patients
Watertown Physician Practices LLC CurrentSince Jan 2, 2017 Accepting new patients
Wheaton Franciscan Medical Group Past Accepting new patients
Commonwealth Medical Group, LLC Pulmonary Disease Past Accepting new patients
Ascension All Saints Hospital, Inc Past Accepting new patients

Locations

13950 W Capitol Dr
Brookfield, WI 53005
Phone (414) 302-5400

5900 S Lake Dr
Cudahy, WI 53110
Phone (414) 489-4055

10101 S 27th St
Franklin, WI 53132
Phone (414) 325-4700

9969 S 27th St
Franklin, WI 53132
Phone (414) 325-2229

10117 74th St
Ste 110
Kenosha, WI 53142
Phone (262) 697-1919

1001 W Glen Oaks Ln
Ste 105
Mequon, WI 53092
Phone (414) 258-8314

2025 W Oklahoma Ave
Ste 121
Milwaukee, WI 53215
Phone (414) 671-1711

2745 W Layton Ave
Ste 206
Milwaukee, WI 53221
Phone (414) 281-9665

1020 N 12th St
Milwaukee, WI 53233
Phone (414) 219-3056

3821 Spring St
Mount Pleasant, WI 53405
Phone (262) 687-8460

3803 Spring St
Ste 600
Mount Pleasant, WI 53405
Phone (262) 687-8312

3803 Spring St
#600
Mount Pleasant, WI 53405
Phone (414) 426-1220

S74W16775 Janesville Rd
Muskego, WI 53150
Phone (414) 422-4747

2000 E Layton Ave
St Francis, WI 53235
Phone (414) 744-7880

123 Hospital Dr
Ste 2009
Watertown, WI 53098
Phone (920) 262-4560

1507 Doctors Ct
Watertown, WI 53094
Phone (920) 261-4111

125 Hospital Dr
Watertown, WI 53098
Phone (920) 261-4210

201 N Mayfair Rd
Fl 2
Wauwatosa, WI 53226
Phone (414) 771-8228

Interoperability endpoints

  • Direct secure messaging: mathew.mathai.1@17022.direct.athenahealth.com

Organizations & group practices 10

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.

Hospital & facility affiliations 7

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

NPI Registry JSON

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

{
    "created_epoch": "1151452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1354665600000",
    "number": "1104854363",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5900 S. LAKE DR.",
            "city": "CUDAHY",
            "state": "WI",
            "postal_code": "53110",
            "telephone_number": "414-744-4000",
            "fax_number": "414-489-4022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5900 S. LAKE DR.",
            "city": "CUDAHY",
            "state": "WI",
            "postal_code": "53110",
            "telephone_number": "414-744-4000",
            "fax_number": "414-489-4022"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATHAI",
        "first_name": "MATHEW",
        "middle_name": "GEORGE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-28",
        "last_updated": "2012-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "WI",
            "license": "45983",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "34650600",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cudahy, WI

Sources for this page

Verify at the official NPI Registry.