Individual provider Active NPI

Liby Mathew, MD

  • Internal Medicine Physician
  • Paramus, NJ
National Provider Identifier
1154587566
Registry record updated Mar 31, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
25MA12057200 Issued in NJ
Practice address
10 Forest Ave Ste 220
Paramus, NJ 07652-5238
Phone
(201) 639-7690
Fax
(862) 406-1650
NPI assigned
Aug 5, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 31, 2026

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 25MA12057200 NJ Primary

Addresses

Primary practice location

10 Forest Ave Ste 220
Paramus, NJ 07652-5238

Mailing address

10 Forest Ave Ste 220
Paramus, NJ 07652-5238
Phone (201) 639-7690

Other names 1

  • Liby Kalloor Abraham Samuel Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, NJ2 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
I20080925000317 NY Practitioner - Internal Medicine 3678640174 Reassigns benefits to 1 organization
I20260128003799 NJ Practitioner - Internal Medicine 3678640174 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
MPV New Jersey MD Services PCGroup PAC ID 5991097669, 146 clinicians
Crystal Run Healthcare Physicians LLPGroup PAC ID 6901792696, 366 clinicians

Practice addresses (Care Compare)

125 Washington Ave
Dumont, NJ 07628-3066
Phone (201) 374-2722

300 Crystal Run Rd
Middletown, NY 10941-4069
Phone (845) 692-6999

Hospital & facility affiliations

  • Montefiore Nyack Hospital Home Health Agency Home health agency, New City, NY, CCN 337168
  • Americare Certified Special Services, Inc Chha Home health agency, Brooklyn, NY, CCN 337290
  • Garnet Health Medical Center Hospital, Middletown, NY, CCN 330126
  • Nyack Hospital Hospital, Nyack, NY, CCN 330104

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MA12057200NJMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
MPV New Jersey MD Services PC CurrentSince Feb 1, 2026 Accepting new patients
Crystal Run Healthcare Physicians LLP CurrentSince Sep 2, 2008 Accepting new patients
MPV New Jersey MD Services PC CurrentSince Feb 1, 2026 Accepting new patients
Crystal Run Healthcare Physicians LLP Internal Medicine CurrentSince Sep 2, 2008 Accepting new patients

Locations

125 Washington Ave
Dumont, NJ 07628
Phone (201) 374-2722

10 Forest Ave
Ste 220
Paramus, NJ 07652
Phone (201) 639-7690

155 Crystal Run Rd
Middletown, NY 10941

300 Crystal Run Rd
Middletown, NY 10941
Phone (845) 692-6999

2 Centerock Rd
West Nyack, NY 10994
Phone (844) 592-7009

Networks

  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H5989

Organizations & group practices 4

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 4

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": "1217894400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1774915200000",
    "number": "1154587566",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 FOREST AVE STE 220",
            "city": "PARAMUS",
            "state": "NJ",
            "postal_code": "076525238",
            "telephone_number": "201-639-7690",
            "fax_number": "862-406-1650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 FOREST AVE STE 220",
            "city": "PARAMUS",
            "state": "NJ",
            "postal_code": "076525238",
            "telephone_number": "201-639-7690",
            "fax_number": "862-406-1650"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATHEW",
        "first_name": "LIBY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-08-05",
        "last_updated": "2026-03-31",
        "certification_date": "2026-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "25MA12057200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LIBY",
            "last_name": "KALLOOR ABRAHAM SAMUEL",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Paramus, NJ

Sources for this page

Verify at the official NPI Registry.