Individual provider Active NPI

Geo T Mathew, PA-C

  • Medical Physician Assistant
  • Bakersfield, CA
National Provider Identifier
1215990205
Registry record updated Feb 2, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA14627 Issued in CA
Practice address
1408 Commercial Way
Bakersfield, CA 93309-0407
Phone
(661) 327-4455
Fax
(661) 633-5484
NPI assigned
Apr 10, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 2, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA14627 CA Primary

Addresses

Primary practice location

1408 Commercial Way
Bakersfield, CA 93309-0407

Mailing address

1408 Commercial Way
Bakersfield, CA 93309-0407
Phone (661) 327-4455

Other identifiers 1

IdentifierTypeStateIssuer
PA0146270MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20110607000032 CA Practitioner - Physician Assistant 2567649262 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1408 Commercial Way
Bakersfield, CA 93309-0406
Phone (661) 327-4455

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
14627CAMDSpeech-Language Pathologist
PA14627CAMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Silver Summit Medical Corporation CurrentSince Jan 17, 2012 Accepting new patients
Silver Summit Medical Corporation Past Accepting new patients

Locations

1408 Commercial Way
Ste E
Bakersfield, CA 93309

1408 Commercial Way
Bakersfield, CA 93309
Phone (661) 327-4455

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1144627200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1328140800000",
    "number": "1215990205",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1408 COMMERCIAL WAY",
            "city": "BAKERSFIELD",
            "state": "CA",
            "postal_code": "933090407",
            "telephone_number": "661-327-4455",
            "fax_number": "661-633-5484"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1408 COMMERCIAL WAY",
            "city": "BAKERSFIELD",
            "state": "CA",
            "postal_code": "933090407",
            "telephone_number": "661-327-4455",
            "fax_number": "661-633-5484"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATHEW",
        "first_name": "GEO",
        "middle_name": "T",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-10",
        "last_updated": "2012-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": "PA14627",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PA0146270",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bakersfield, CA

Sources for this page

Verify at the official NPI Registry.