Individual provider Active NPI

Josiah Ezekiel Mathieu

  • Physician Assistant
  • Roanoke, VA
National Provider Identifier
1235027707
Registry record updated Feb 25, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0110011585 Issued in VA
Practice address
1906 Belleview Ave SE
Roanoke, VA 24014-1838
Phone
(540) 981-7000
Fax
(540) 985-6920
NPI assigned
Jun 25, 2025
Sex
Unspecified or another gender identity
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 25, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 0110011585 VA Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

1906 Belleview Ave SE
Roanoke, VA 24014-1838

Mailing address

213 S Jefferson St Ste 1006
Roanoke, VA 24011-1713

Other practice location 1

2857 Envoy Dr
Roanoke, VA 24019-3321
Phone (260) 517-3843

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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
I20260317001825 VA Practitioner - Physician Assistant 8224511399 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2025
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

213 S Jefferson St
Suite 1006
Roanoke, VA 24011-1713

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0110011585VAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Carilion Giles Community Hospital CurrentSince Apr 5, 2026 Accepting new patients
Carilion Medical Center CurrentSince Apr 5, 2026 Accepting new patients
Carilion Healthcare Corporation CurrentSince Apr 5, 2026 Accepting new patients
Carilion Emergency Services, Inc. CurrentSince Apr 5, 2026 Accepting new patients
Carilion Medical Center CurrentSince Apr 5, 2026 Accepting new patients
Carilion Healthcare Corporation CurrentSince Apr 5, 2026 Accepting new patients
Carilion Medical Center CurrentSince Apr 5, 2026 Accepting new patients
Carilion Rockbridge Community Hospital CurrentSince Apr 5, 2026 Accepting new patients
Carilion Giles Community Hospital CurrentSince Apr 5, 2026 Accepting new patients

Locations

213 S Jefferson St
Ste 1006
Roanoke, VA 24011
Phone (540) 224-5353

1906 Belleview Ave SE
Roanoke, VA 24014
Phone (540) 853-0222

Organizations & group practices 9

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": "1750809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1771977600000",
    "number": "1235027707",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "213 S JEFFERSON ST STE 1006",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240111713"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1906 BELLEVIEW AVE SE",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240141838",
            "telephone_number": "540-981-7000",
            "fax_number": "540-985-6920"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2857 Envoy Dr",
            "address_purpose": "LOCATION",
            "city": "Roanoke",
            "state": "VA",
            "postal_code": "240193321",
            "country_code": "US",
            "telephone_number": "260-517-3843",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MATHIEU",
        "first_name": "JOSIAH",
        "middle_name": "EZEKIEL",
        "sole_proprietor": "NO",
        "sex": "X",
        "enumeration_date": "2025-06-25",
        "last_updated": "2026-02-25",
        "certification_date": "2026-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VA",
            "license": "0110011585",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roanoke, VA

Sources for this page

Verify at the official NPI Registry.