Active NPI
Dillon Koshy Mathew, PA C
- Family Medicine Physician
- Euless, TX
National Provider Identifier
1215910468
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- PA03223
- Practice address
- 412 N Main St
Ste 100
Euless, TX 76039-3652 - Phone
- (817) 358-5800
- Fax
- (817) 283-7686
- NPI assigned
- Nov 22, 2005
- Last updated
- Feb 14, 2012
- 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 |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | PA03223 | TX | Primary |
Addresses
Primary practice location
412 N Main St
Ste 100
Euless, TX 76039-3652
Mailing address
PO Box 210907
Kaner Medical Group
Bedford, TX 76095-7907
Phone (817) 358-5800
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)
- Enrolled
- Credentials
- Physician Assistant
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Amatus Health Care LLC | Current | Accepting new patients | |
| Healthcare Associates of Irving PLLC | Family Medicine | Past | Accepting new patients |
| Kaner Medical Group PA | Family Medicine | Past | Accepting new patients |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Home Health Agency
- Farmers Branch, TX
- NPI 1619295268
-
- Family Medicine Physician
- Irving, TX
- NPI 1467413625
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1132617600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1329177600000",
"number": "1215910468",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 210907",
"address_2": "KANER MEDICAL GROUP",
"city": "BEDFORD",
"state": "TX",
"postal_code": "760957907",
"telephone_number": "817-358-5800",
"fax_number": "817-283-7686"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "412 N MAIN ST",
"address_2": "STE 100",
"city": "EULESS",
"state": "TX",
"postal_code": "760393652",
"telephone_number": "817-358-5800",
"fax_number": "817-283-7686"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MATHEW",
"first_name": "DILLON",
"middle_name": "KOSHY",
"credential": "PA C",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-11-22",
"last_updated": "2012-02-14",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "TX",
"license": "PA03223",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Euless, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.