Individual provider Active NPI

Amy Ann Mathew, M.D.

  • Pediatrics Physician
  • Frederick, MD
National Provider Identifier
1205083102
Registry record updated Jan 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
D0068729 Issued in MD
Practice address
3534 Urbana Pike Ste a
Frederick, MD 21704-7786
Phone
(240) 341-1090
Fax
(240) 877-7110
NPI assigned
Aug 21, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 13, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X D0068729 MD Primary

Addresses

Primary practice location

3534 Urbana Pike Ste a
Frederick, MD 21704-7786

Mailing address

3534 Urbana Pike Ste a
Frederick, MD 21704-7786
Phone (240) 341-1090

Other practice location 1

1475 Taney Ave
Ste 201
Frederick, MD 21702-4747
Phone (301) 662-1930

Other identifiers 1

IdentifierTypeStateIssuer
028290100MedicaidMD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
D0068729MDMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Frederick Health Hospital Inc Past Accepting new patients
Urbana Pediatrics, LLC Pediatrics PastSince Jan 17, 2021 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: amy.mathew.1@19052.direct.athenahealth.com
  • FHIR API: https://api.platform.athenahealth.com/19052/brand/1/csg/1/fhir/r4

Organizations & group practices 2

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": "1219276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610496000000",
    "number": "1205083102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3534 URBANA PIKE STE A",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217047786",
            "telephone_number": "240-341-1090",
            "fax_number": "240-877-7110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3534 URBANA PIKE STE A",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217047786",
            "telephone_number": "240-341-1090",
            "fax_number": "240-877-7110"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1475 Taney Ave",
            "address_2": "STE 201",
            "address_purpose": "LOCATION",
            "city": "Frederick",
            "state": "MD",
            "postal_code": "217024747",
            "country_code": "US",
            "telephone_number": "301-662-1930",
            "fax_number": "240-379-6710",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MATHEW",
        "first_name": "AMY",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-08-21",
        "last_updated": "2021-01-13",
        "certification_date": "2021-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MD",
            "license": "D0068729",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "028290100",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Frederick, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.