Individual provider Active NPI

Blessy Mathew, FNP-C

  • Family Nurse Practitioner
  • Dallas, TX
National Provider Identifier
1194558007
Registry record updated Apr 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
1172567 Issued in TX
Practice address
3310 Live Oak St Ste 300
Dallas, TX 75204-6149
Phone
(972) 942-3410
NPI assigned
Aug 26, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 1172567 TX Primary

Addresses

Primary practice location

3310 Live Oak St Ste 300
Dallas, TX 75204-6149

Mailing address

3310 Live Oak St Ste 300
Dallas, TX 75204-6149
Phone (972) 942-3410

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20250425000488 TX Practitioner - Nurse Practitioner 9931625647 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wellmed Medical Group PAGroup PAC ID 4880657386, 666 clinicians

Practice addresses (Care Compare)

3310 Live Oak St
Suite 300
Dallas, TX 75204-6149
Phone (972) 942-3410

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1172567TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Wellmed Medical Group, PA CurrentSince Apr 21, 2025 Accepting new patients
Wellmed Medical Group, P.a. CurrentSince Apr 21, 2025 Accepting new patients
Gary E Goff MD PA CurrentSince Jan 1, 2026 Accepting new patients

Locations

3310 Live Oak St
Ste 300
Dallas, TX 75204
Phone (972) 942-3410

8440 Walnut Hill Ln
Ste 420
Dallas, TX 75231
Phone (214) 879-9966

5939 Harry Hines Blvd
Ste 310
Dallas, TX 75235
Phone (214) 279-9966

3310 Live Oak St
Ste 30
Dallas, TX 75204
Phone (972) 942-3410

6157 NW Loop 410
Ste 124
San Antonio, TX 78238
Phone (210) 523-1411

Organizations & group practices 3

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": "1724630400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745884800000",
    "number": "1194558007",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3310 LIVE OAK ST STE 300",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752046149",
            "telephone_number": "972-942-3410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3310 LIVE OAK ST STE 300",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752046149",
            "telephone_number": "972-942-3410"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATHEW",
        "first_name": "BLESSY",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-08-26",
        "last_updated": "2025-04-29",
        "certification_date": "2025-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "1172567",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.