Individual provider Active NPI

Jinu Puthenparampil Mathew, MD

  • Internal Medicine Physician
  • Bay City, MI
National Provider Identifier
1114301942
Registry record updated Mar 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
4301107217 Issued in MI
Practice address
3175 W Professional Dr
Suite 1
Bay City, MI 48706
Phone
(989) 667-3400
Fax
(989) 667-2114
NPI assigned
Jul 10, 2015
Last updated
Mar 5, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 5, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 4301107217 MI Primary

Addresses

Primary practice location

3175 W Professional Dr
Suite 1
Bay City, MI 48706

Mailing address

3175 W Professional Dr
Suite 1
Bay City, MI 48706
Phone (989) 667-3400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20180731001009 MI Practitioner - Internal Medicine 1153630991 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
McLaren Bay RegionGroup PAC ID 5597659011, 110 clinicians

Practice addresses (Care Compare)

3175 W Professional Dr
Bay Regional Medical Center
Bay City, MI 48706-2823
Phone (989) 894-3278

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301107217MIMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
McLaren Bay Region Internal Medicine CurrentSince Aug 26, 2024 Accepting new patients
McLaren Bay Region CurrentSince Aug 26, 2024 Accepting new patients
McLaren Bay Region Past Accepting new patients

Locations

1900 Columbus Ave
Bay City, MI 48708
Phone (989) 894-3000

3175 Professional Ct
Ste 1
Bay City, MI 48706
Phone (989) 667-3400

2940 Health Pkwy
Mt Pleasant, MI 48858
Phone (989) 466-2877

Interoperability endpoints

  • Direct secure messaging: jputhenparampil75708@mymichiganhealth.midirect.net

Organizations & group practices 3

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.

Hospital & facility affiliations 1

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": "1436486400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741132800000",
    "number": "1114301942",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3175 W PROFESSIONAL DR",
            "address_2": "SUITE 1",
            "city": "BAY CITY",
            "state": "MI",
            "postal_code": "48706",
            "telephone_number": "989-667-3400",
            "fax_number": "989-667-2114"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3175 W PROFESSIONAL DR",
            "address_2": "SUITE 1",
            "city": "BAY CITY",
            "state": "MI",
            "postal_code": "48706",
            "telephone_number": "989-667-3400",
            "fax_number": "989-667-2114"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATHEW",
        "first_name": "JINU",
        "middle_name": "PUTHENPARAMPIL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-07-10",
        "last_updated": "2025-03-05",
        "certification_date": "2025-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301107217",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bay City, MI

Sources for this page

Verify at the official NPI Registry.