Renjan Roy Mathew, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

36436 Issued in TX

Practice address

600 E John Carpenter Fwy
Ste 291
Irving, TX 75062

Phone

(469) 444-3226

NPI assigned

May 7, 2014

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

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.

• DFW Neuropsychology Consultants LLC

  • Clinical Psychologist
  • Irving, TX
  • NPI 1568252757
  NPD Authorized official
• Hanifa Healthcare PC

  • Psychiatry Physician
  • Fort Worth, TX
  • NPI 1427629450
  NPD (past)

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

{
    "created_epoch": "1399420800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1558569600000",
    "number": "1235549650",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1636 SANTA ANITA BLVD",
            "city": "IRVING",
            "state": "TX",
            "postal_code": "750604887",
            "telephone_number": "469-585-5393"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 E JOHN CARPENTER FWY",
            "address_2": "STE 291",
            "city": "IRVING",
            "state": "TX",
            "postal_code": "75062",
            "telephone_number": "469-444-3226"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATHEW",
        "first_name": "RENJAN",
        "middle_name": "ROY",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-05-07",
        "last_updated": "2019-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "TX",
            "license": "36436",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "TX",
            "license": "36436",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sherry Lynnette Masterson, PA-C
• Aditi Masurkar, MSOT, OTR/L
• Alexandra Katherine Mata, PTA
• Jennifer Garcia Mata, PA-C
• Lejoy Mathew, DPT
• Shauna Mathew, FNP
• Smitha Mathew
• Stanley Mathew, FNP-C
• Jerril Mathews, OTR, MOT
• Sunil Mathews, M.D.

• Clinical Psychologist in Irving, TX
• Providers in Irving, TX by specialty
• Clinical Psychologist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.