Alexander P Mathai, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

01062241A Issued in IN

Practice address

2121 Lake Ave
Fort Wayne, IN 46805-5100

Phone

(260) 526-5431

NPI assigned

Jul 3, 2006

Last updated

Aug 24, 2021By the provider in NPPES

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 5

Medicare fee-for-service enrollment

Enrolled in IN, IL, GA, WV, WI, AL, OH7 enrollments

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 7

Specialty

Internal Medicine

Education

Other, 1998

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Allen County Internal Medicine PCGroup PAC ID 0143447060, 2 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Solace Hospice LLC Hospice, Roanoke, IN, CCN 151662
• Canterbury Nursing and Rehabilitation Center Nursing home, Fort Wayne, IN, CCN 155656

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

• The Health and Hospital Corporation of Marion County

  dba Canterbury Nursing and Rehabilitation Center

  • Skilled Nursing Facility
  • Fort Wayne, IN
  • NPI 1881940617

  Adp of the SNF, Operational/Managerial Control

  CMS ownership

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.

• Allen County Internal Medicine PC

  • Internal Medicine Physician
  • Fort Wayne, IN
  • NPI 1356755813
  Medicare reassignment Care Compare group NPD
• Sound Physicians of Indiana, LLC

  • Hospitalist Physician
  • Gary, IN
  • NPI 1528311149

  Internal Medicine

  Medicare reassignment NPD
• Cogent Healthcare of Georgia PC

  • Internal Medicine Physician
  • Macon, GA
  • NPI 1609827823
  Medicare reassignment NPD
• Hospitalist Medicine Physicians of Alabama-TCG, Inc.

  • Internal Medicine Physician
  • Brentwood, TN
  • NPI 1144709601

  AL

  Medicare reassignment NPD
• Hospitalist Medicine Physicians of Ohio, Professional Corporation

  • Internal Medicine Physician
  • Columbus, OH
  • NPI 1043572290
  Medicare reassignment NPD
• Hospitalist Medicine Physicians of West Virginia, PLLC

  • Internal Medicine Physician
  • Wheeling, WV
  • NPI 1649575101
  Medicare reassignment NPD
• Hospitalist Medicine Physicians of Wisconsin, LTD

  • Internal Medicine Physician
  • Kenosha, WI
  • NPI 1699902809
  Medicare reassignment NPD
• Sound Physicians of Illinois, LLC

  • Hospitalist Physician
  • Bridgeton, MO
  • NPI 1043598865

  IL

  Medicare reassignment
• Sound Physicians of Indiana, LLC

  dba Sound Physicinas of Indiana

  • Hospitalist Physician
  • Terre Haute, IN
  • NPI 1184063257

  Internal Medicine

  NPD

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

• Solace Hospice, LLC

  • Community Based Hospice Care Agency
  • Roanoke, IN
  • NPI 1366200511
  Care Compare affiliation
• The Health and Hospital Corporation of Marion County

  dba Canterbury Nursing and Rehabilitation Center

  • Skilled Nursing Facility
  • Fort Wayne, IN
  • NPI 1881940617

  Nursing home

  Care Compare affiliation

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

{
    "created_epoch": "1151884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629763200000",
    "number": "1104856608",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12515 GOLDEN HARVEST DR",
            "address_2": "CREDENTIALING DEPARTMENT",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468459031",
            "telephone_number": "217-714-0220",
            "fax_number": "260-387-6194"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2121 LAKE AVE",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468055100",
            "telephone_number": "260-526-5431"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12515 Golden Harvest Dr",
            "address_2": "Credentialing Department",
            "address_purpose": "LOCATION",
            "city": "Fort Wayne",
            "state": "IN",
            "postal_code": "468459031",
            "country_code": "US",
            "telephone_number": "217-714-0220",
            "fax_number": "260-387-6194",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MATHAI",
        "first_name": "ALEXANDER",
        "middle_name": "P",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-03",
        "last_updated": "2021-08-24",
        "certification_date": "2021-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IN",
            "license": "01062241A",
            "primary": true
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "IN",
            "license": "01062241",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "11589278",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2680111",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200827920",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD",
            "identifier": "POO390087",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000485120",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Marni F Mastbaum, MS ED
• Emily Mastelou-Page, NNP
• Kirk E Masten, DO
• Stacy Rose Masters, RN
• Jennifer Diane Mata
• Sneha Mary Mathen, DDS
• Catherine A. Mather-Grimes, LSW
• Bethann Mathews
• Morgan Mathews, PA-C
• Scott M Mathewson, OTR/L

• Internal Medicine Physician in Fort Wayne, IN
• Providers in Fort Wayne, IN by specialty
• Internal Medicine Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data; 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.