Individual provider Active NPI

Gina Thresia Mathew, NP

  • Psychiatric/Mental Health Nurse Practitioner
  • Hinsdale, IL
National Provider Identifier
1194419168
Registry record updated Sep 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
209.027472 Issued in IL
Practice address
901 N Elm St Ste 275
Hinsdale, IL 60521-3632
Phone
(630) 428-7890
NPI assigned
Jun 5, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 20, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 209.027472 IL Primary

Addresses

Primary practice location

901 N Elm St Ste 275
Hinsdale, IL 60521-3632

Mailing address

901 N Elm St Ste 275
Hinsdale, IL 60521-3632
Phone (630) 428-7890

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231002001251 IL Practitioner - Nurse Practitioner 7719331222 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Rockford Psychiatric Medical Services SCGroup PAC ID 6901089515, 154 clinicians

Practice addresses (Care Compare)

444 N Northwest Hwy
Suite 202
Park Ridge, IL 60068-3271
Phone (847) 692-7101

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Rockford Psychiatric Medical Services, S.C. CurrentSince Jun 14, 2024 Accepting new patients
Edgewood Clinical Services, P.C. Psychiatric/Mental Health CurrentSince Sep 18, 2023 Accepting new patients
Edgewood Clinical Services, P.C. Past Accepting new patients
Psychology Specialists LTD Past Accepting new patients

Locations

808 S Eldorado Rd
Ste 102
Bloomington, IL 61704
Phone (309) 212-6007

901 N Elm St
Ste 275
Hinsdale, IL 60521
Phone (331) 529-8712

3027 English Rows Ave
Ste 201
Naperville, IL 60564

2948 Artesian Rd
Ste 112
Naperville, IL 60564
Phone (630) 328-0165

444 N Northwest Hwy
Ste 202
Park Ridge, IL 60068
Phone (847) 268-0280

1639 N Alpine Rd
Ste 260
Rockford, IL 61107
Phone (815) 395-1500

Interoperability endpoints

  • Direct secure messaging: gina.mathew.1@25899.direct.athenahealth.com

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1685923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695168000000",
    "number": "1194419168",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "901 N ELM ST STE 275",
            "city": "HINSDALE",
            "state": "IL",
            "postal_code": "605213632",
            "telephone_number": "630-428-7890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 N ELM ST STE 275",
            "city": "HINSDALE",
            "state": "IL",
            "postal_code": "605213632",
            "telephone_number": "630-428-7890"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATHEW",
        "first_name": "GINA",
        "middle_name": "THRESIA",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-06-05",
        "last_updated": "2023-09-20",
        "certification_date": "2023-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "IL",
            "license": "209.027472",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hinsdale, IL

Sources for this page

Verify at the official NPI Registry.