Individual provider Active NPI

Anjeli Eliza Mathew, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • East Setauket, NY
National Provider Identifier
1245199090
Registry record updated Jan 19, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
407590 Issued in NY
Practice address
18 Mink LN
East Setauket, NY 11733-3508
Phone
(201) 937-9218
NPI assigned
Jan 19, 2026
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 19, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 407590 NY Primary

Addresses

Primary practice location

18 Mink LN
East Setauket, NY 11733-3508

Mailing address

18 Mink LN
East Setauket, NY 11733-3508
Phone (201) 937-9218

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
407590NYMDPsychiatric/Mental Health Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1768780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1768780800000",
    "number": "1245199090",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18 MINK LN",
            "city": "EAST SETAUKET",
            "state": "NY",
            "postal_code": "117333508",
            "telephone_number": "201-937-9218"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18 MINK LN",
            "city": "EAST SETAUKET",
            "state": "NY",
            "postal_code": "117333508",
            "telephone_number": "201-937-9218"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATHEW",
        "first_name": "ANJELI",
        "middle_name": "ELIZA",
        "credential": "PMHNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2026-01-19",
        "last_updated": "2026-01-19",
        "certification_date": "2026-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NY",
            "license": "407590",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Setauket, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.