Individual provider Active NPI

Amy Mathew, M.D.

  • Emergency Medicine Physician
  • Tampa, FL
National Provider Identifier
1114288123
Registry record updated Apr 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
ME140540 Issued in FL
Practice address
1 Tampa General Cir
Tampa, FL 33606-3571
Phone
(239) 281-7765
NPI assigned
Jun 6, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 275199 NY
Emergency Medicine Physician 207P00000X ME140540 FL Primary

Addresses

Primary practice location

1 Tampa General Cir
Tampa, FL 33606-3571

Mailing address

6211 Knob Tree Dr FL USA
Lithia, FL 33547-4922
Phone (239) 281-7765

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, FL2 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 2

Enrollment IDStateProvider typePAC IDDetails
I20151208002987 NY Practitioner - Emergency Medicine 1557662954 Reassigns benefits to 2 organizations
I20200305002203 FL Practitioner - Emergency Medicine 1557662954 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Inphynet Contracting Services LLCGroup PAC ID 7416865811, 169 clinicians
Paragon Emergency Services LLCGroup PAC ID 8628153087, 401 clinicians

Practice addresses (Care Compare)

1 Tampa General Cir
Tampa, FL 33606-3571
Phone (813) 844-7000

200 Ave F NE
Winter Haven, FL 33881-4131
Phone (863) 293-1121

Hospital & facility affiliations

  • Tampa General Hospital Hospital, Tampa, FL, CCN 100128
  • Winter Haven Hospital Hospital, Winter Haven, FL, CCN 100052

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME140540FLMDEmergency Medicine Physician
275199NYMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Paragon Emergency Services LLC Emergency Medicine CurrentSince Feb 24, 2020 Accepting new patients
Maimonides Faculty Practice Plan CurrentSince Sep 29, 2015 Accepting new patients
Paragon Contracting Services LLC Emergency Medicine CurrentSince Feb 24, 2020 Accepting new patients
Inphynet Contracting Services LLC Emergency Medicine CurrentSince May 16, 2020 Accepting new patients
Tampa General Hospital Current Accepting new patients
Maimonides Medical Center Current Accepting new patients

Locations

3625 University Blvd S
Jacksonville, FL 32216
Phone (904) 333-9404

951 N Washington Ave
Titusville, FL 32796
Phone (302) 325-5511

1 Tampa General Cir
University of Tampa, FL 33606
Phone (813) 251-5822

200 Avenue F NE
Winter Haven, FL 33881
Phone (863) 292-4652

4802 10th Ave
Brooklyn, NY 11219
Phone (718) 283-8724

2525 Kings Hwy
Brooklyn, NY 11229
Phone (718) 692-5300

Networks

  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H5989

Interoperability endpoints

  • Direct secure messaging: amathew169158@direct.tgh.org
  • Direct secure messaging: amymathew@mai.allscriptsdirect.net
  • FHIR API: https://epicproxy.et0761.epichosted.com/FHIRProxy/api/FHIR/R4/

Organizations & group practices 8

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 2

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": "1338940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1585872000000",
    "number": "1114288123",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6211 KNOB TREE DR FL USA",
            "city": "LITHIA",
            "state": "FL",
            "postal_code": "335474922",
            "telephone_number": "239-281-7765"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 TAMPA GENERAL CIR",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336063571",
            "telephone_number": "239-281-7765"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATHEW",
        "first_name": "AMY",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-06-06",
        "last_updated": "2020-04-03",
        "certification_date": "2020-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NY",
            "license": "275199",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "FL",
            "license": "ME140540",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

Verify at the official NPI Registry.