Individual provider Active NPI

Antony Mathew, M.D.

  • Emergency Medicine Physician
  • Vallejo, CA
National Provider Identifier
1184156010
Registry record updated Feb 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
ME151315 Issued in FL
Practice address
300 Hospital Dr
Vallejo, CA 94589-2574
Phone
(925) 225-5837
Fax
(925) 225-5838
NPI assigned
Mar 30, 2017
Last updated
Feb 22, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 22, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Emergency Medicine Physician 207P00000X A169892 CA
Emergency Medicine Physician 207P00000X ME151315 FL Primary

Addresses

Primary practice location

300 Hospital Dr
Vallejo, CA 94589-2574

Mailing address

15 Woodlawn Ave Apt B
Albany, NY 12208-3225
Phone (239) 822-8333

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20211021000382 FL Practitioner - Emergency Medicine 1052656048 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Emergency Physicians of St Petersburg PAGroup PAC ID 1658433883, 18 clinicians

Practice addresses (Care Compare)

701 6TH St S
St Petersburg, FL 33701-4814
Phone (727) 553-7300

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Physicians of Pinellas PA Emergency Medicine CurrentSince Mar 21, 2023 Accepting new patients
Paragon Contracting Services LLC Emergency Medicine CurrentSince Sep 1, 2021 Accepting new patients
Emergency Physicians of Crossroads Emergency Medicine CurrentSince Aug 27, 2023 Accepting new patients
Emergency Physicians of St Petersburg PA Emergency Medicine CurrentSince Feb 1, 2023 Accepting new patients
Paragon Emergency Services LLC Emergency Medicine CurrentSince Sep 1, 2021 Accepting new patients

Locations

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

3070 Grand Ave
Pinellas Park, FL 33782
Phone (727) 553-7300

1800 66th St N
St Petersburg, FL 33710
Phone (727) 823-1234

701 6th St S
St Petersburg, FL 33701
Phone (727) 450-1144

1643 NW 136th Ave
Ste 100
Sunrise, FL 33323
Phone (865) 500-1325

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

Organizations & group practices 5

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": "1490832000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677024000000",
    "number": "1184156010",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 WOODLAWN AVE APT B",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122083225",
            "telephone_number": "239-822-8333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 HOSPITAL DR",
            "city": "VALLEJO",
            "state": "CA",
            "postal_code": "945892574",
            "telephone_number": "925-225-5837",
            "fax_number": "925-225-5838"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATHEW",
        "first_name": "ANTONY",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-03-30",
        "last_updated": "2023-02-22",
        "certification_date": "2023-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "A169892",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "FL",
            "license": "ME151315",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vallejo, CA

Sources for this page

Verify at the official NPI Registry.