Active NPI
Imre Mathe, DDS
- Dentist
- Forest Hills, NY
National Provider Identifier
1184742017
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 0411821
- Practice address
- 112 47 Queens Boulevard
# 201
Forest Hills, NY 11375 - Phone
- (718) 544-9414
- Fax
- (718) 544-9417
- NPI assigned
- Mar 27, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 0411821 | NY | Primary |
Addresses
Primary practice location
112 47 Queens Boulevard
# 201
Forest Hills, NY 11375
Mailing address
112 47 Queens Boulevard
# 201
Forest Hills, NY 11375
Phone (718) 544-9414
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 01099467 | Medicaid | NY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0411821 | NY | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174953600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1184742017",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "112 47 QUEENS BOULEVARD",
"address_2": "# 201",
"city": "FOREST HILLS",
"state": "NY",
"postal_code": "11375",
"telephone_number": "718-544-9414",
"fax_number": "718-544-9417"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "112 47 QUEENS BOULEVARD",
"address_2": "# 201",
"city": "FOREST HILLS",
"state": "NY",
"postal_code": "11375",
"telephone_number": "718-544-9414",
"fax_number": "718-544-9417"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MATHE",
"first_name": "IMRE",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-03-27",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "NY",
"license": "0411821",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "01099467",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Forest Hills, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.