Individual provider Active NPI

Nija Mathew

  • Diagnostic Radiology Physician
  • New Hyde Park, NY
National Provider Identifier
1225355332
Registry record updated Apr 28, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
60 250772 Issued in NY
Practice address
27005 76TH Ave
New Hyde Park, NY 11040-1402
Phone
(718) 470-4585
NPI assigned
Apr 28, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 28, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 60 250772 NY Primary

Addresses

Primary practice location

27005 76TH Ave
New Hyde Park, NY 11040-1402

Mailing address

27005 76TH Ave
New Hyde Park, NY 11040-1402
Phone (718) 470-4585

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140123000326 NY Practitioner - Diagnostic RadiologyPractitioner - Other (Physician) 2062640931 Reassigns benefits to 8 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
State University of Ny Upstate Medical University, 2007
Medicare assignment
May accept Medicare assignment
Group practices
Optum Medical Care PCGroup PAC ID 9931013240, 1,013 clinicians
Optum Urgent Care PLLCGroup PAC ID 8628299518, 68 clinicians

Practice addresses (Care Compare)

15636 A Crossbay Blvd
Howard Beach, NY 11414-2745
Phone (718) 738-0700

2960 Victory Blvd
Staten Island, NY 10314-6605
Phone (718) 370-2014

90 S Bedford Rd
Mount Kisco, NY 10549-3412
Phone (914) 241-1050

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
60 250772NYMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
New York University CurrentSince Mar 15, 2018 Accepting new patients
Jamaica Hospital CurrentSince Aug 1, 2019 Accepting new patients
Optum Medical Care, P.C. Diagnostic Radiology CurrentSince Jan 15, 2023 Accepting new patients
North Shore Medical Group of the Mount Sinai School of Medicine CurrentSince Oct 1, 2016 Accepting new patients
Fpa Hospital Based Diagnostic Radiology CurrentSince Jan 1, 2015 Accepting new patients
Fpa Hospital Based CurrentSince Jan 1, 2015 Accepting new patients
Optum Urgent Care, PLLC CurrentSince Oct 27, 2021 Accepting new patients
North Shore Medical Group of the Mount Sinai School of Medicine Diagnostic Radiology Current Accepting new patients
Jamaica Hospital CurrentSince Aug 1, 2019 Accepting new patients
Fpa Hospital Based Current Accepting new patients
Harlem Medical Associates PC CurrentSince Mar 10, 2014 Accepting new patients
Optum Medical Care, P.C. CurrentSince Jan 15, 2023 Accepting new patients
New York University CurrentSince Mar 15, 2018 Accepting new patients
North Shore Medical Group of the Mount Sinai School of Medicine CurrentSince Oct 1, 2016 Accepting new patients

Locations

2322 30th Ave
Astoria, NY 11102
Phone (718) 267-2763

120 New York Ave
Huntington, NY 11743
Phone (631) 351-3766

3712 82nd St
Jackson Hts, NY 11372
Phone (718) 879-1600

555 N Broadway
Jericho, NY 11753
Phone (516) 597-5070

259 1st St
Mineola, NY 11501
Phone (516) 576-1820

90 S Bedford Rd
Mount Kisco, NY 10549
Phone (914) 242-1050

110 S Bedford Rd
Mount Kisco, NY 10549
Phone (763) 910-9192

2800 Marcus Ave
New Hyde Park, NY 11042
Phone (516) 622-6131

1176 5th Ave
New York, NY 10029
Phone (212) 241-6237

506 Malcolm X Blvd
New York, NY 10037
Phone (212) 939-1000

27005 76th Ave
North New Hyde Pk, NY 11040

300 Community Dr
Plandome, NY 11030

13303 Jamaica Ave
Richmond Hill, NY 11418
Phone (718) 206-6942

8900 Van Wyck Expy
Richmond Hill, NY 11418
Phone (718) 206-6088

13303 Jamaica Ave
#13292
Richmond Hill, NY 11418
Phone (718) 291-3276

2960 Victory Blvd
Staten Island, NY 10314
Phone (718) 370-2014

Philadelphia, PA 19195

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H9678

Organizations & group practices 14

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.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1272412800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1272412800000",
    "number": "1225355332",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27005 76TH AVE",
            "city": "NEW HYDE PARK",
            "state": "NY",
            "postal_code": "110401402",
            "telephone_number": "718-470-4585"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27005 76TH AVE",
            "city": "NEW HYDE PARK",
            "state": "NY",
            "postal_code": "110401402",
            "telephone_number": "718-470-4585"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATHEW",
        "first_name": "NIJA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-04-28",
        "last_updated": "2010-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NY",
            "license": "60 250772",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Hyde Park, NY

Sources for this page

Verify at the official NPI Registry.