Sajida Mathew, MD
Individual provider Active NPI Psychiatry Physician · Rockledge, FL
NPI 1164510509 · NPPES record last updated Jun 27, 2024
Key facts
- NPI
- 1164510509
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Psychiatry Physician 2084P0800X
- License
- ME119338 (FL)
- Practice address
- 220 Barton Blvd Unit C-14
Rockledge, FL 32955-2742 - Phone
- (321) 241-6800
- Fax
- (321) 241-6890
- NPI assigned
- Oct 11, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 24
Medicare Care Compare profile
- Specialty
- Psychiatry
- Education
- Other, 1996
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Brevard Health Alliance Inc
Practice addresses (Care Compare)
17 Silver Palm Ave
Melbourne, FL 32901-3123
Phone (321) 241-6800
220 Barton Blvd
Rockledge, FL 32955-2742
Phone (321) 241-6800
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in FL
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20140822001363 | FL | Practitioner - Psychiatry | 1850284233 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ME119338 | FL | MD | Psychiatry Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Personal Recovery Network LLC | Psychiatry | Current |
Accepting new patients |
| Parwati Maddali MD Professional Association | Psychiatry | Current |
Accepting new patients |
| New Center Community Mental Health Services | Past |
Accepting new patients | |
| List Psychological Services, PLC | Psychiatry | Past | Accepting new patients |
| Tuscola County Community Mental Health Services Board | Past |
Accepting new patients | |
| New Center Community Mental Health Services | Past | Accepting new patients |
Locations
260 Lookout Pl
Ste 202
Maitland, FL 32751
Phone (407) 537-9450
6718 Lake Nona Blvd
Orlando, FL 32827
Phone (407) 476-1222
845 Executive Ln
Ste 100
Rockledge, FL 32955
Phone (321) 631-4222
Interoperability endpoints
- sajida.mathew@bha.eclinicaldirectplus.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | ME119338 | FL | Yes |
Addresses
Primary practice location
220 Barton Blvd Unit C-14
Rockledge, FL 32955-2742
Mailing address
PO Box 1137
Melbourne, FL 32902-1137
Phone (321) 952-9696
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| ME119338 | Other | FL | FL STATE LICENSE |
| 4848294 | Medicaid | MI |
Other providers in Rockledge, FL
- Merelyn Azucena Martinez
- Nildy D Martinez
- Patrick Mason
- Tracy Lee Massey
- Stephan A Massiah
- Nyianni Mathis
- Heidi Mattessich
- April Matthews
- Courtney June Mauro
- Alan Michael May II
All providers in Rockledge, FL · Psychiatry Physician in Florida
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 27, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.