Individual provider Active NPI

James Mathew, MD

  • Cardiovascular Disease Physician
  • Milwaukee, WI
National Provider Identifier
1245278852
Registry record updated Jun 12, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
45947 Issued in WI
Practice address
2350 N Lake Dr
Suite 400
Milwaukee, WI 53211-4528
Phone
(414) 271-1633
Fax
(414) 271-5071
NPI assigned
Jun 4, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 45947 WI Primary

Addresses

Primary practice location

2350 N Lake Dr
Suite 400
Milwaukee, WI 53211-4528

Mailing address

4425 N Port Washington Rd
Attn: Csmcp Clinic Credentialing
Glendale, WI 53212-1082
Phone (414) 271-1633

Other identifiers 1

IdentifierTypeStateIssuer
34446900MedicaidWI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI, IL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20031125000849 WI Practitioner - Interventional CardiologyPractitioner - Cardiovascular Disease (Cardiology) 8022912500 Reassigns benefits to 1 organization
I20181231000166 IL Practitioner - Cardiovascular Disease (Cardiology) 8022912500

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Columbia St. Mary's Hospital Milwaukee, Inc Current Accepting new patients
Columbia St. Mary's Hospital Milwaukee, Inc CurrentSince Feb 1, 2006 Accepting new patients
Osf Multi-Specialty Group CurrentSince Dec 31, 2018 Accepting new patients
Central PA Pharmacy LLC. Current Accepting new patients
Columbia St. Mary's Hospital Milwaukee Inc CurrentSince Feb 1, 2006 Accepting new patients
Gibson Community Hospital Association Past Accepting new patients
Columbia St. Mary's Hospital Milwaukee, Inc Past Accepting new patients
Franklin Cardiac Center LLC Past Accepting new patients
Ascension Medical Group-Southeast Wisconsin Inc Past Accepting new patients

Locations

1505 Eastland Dr
Ste 330
Bloomington, IL 61701
Phone (309) 662-3311

1505 Eastland Dr
Ste 350
Bloomington, IL 61701
Phone (309) 663-1222

8600 State Route 91
Ste 130
Peoria, IL 61615
Phone (309) 683-5050

N112W15415 Mequon Rd
Germantown, WI 53022
Phone (262) 250-7800

6900 N Port Washington Rd
Glendale, WI 53217
Phone (414) 270-8100

4425 N Port Washington Rd
Glendale, WI 53212
Phone (414) 326-2218

13133 N Port Washington Rd
Mequon, WI 53097
Phone (262) 243-5850

2315 N Lake Dr
Ste 613
Milwaukee, WI 53211
Phone (414) 271-1633

2350 N Lake Dr
Ste 400
Milwaukee, WI 53211
Phone (414) 270-1633

2900 W Oklahoma Ave
Milwaukee, WI 53215
Phone (414) 385-2590

1317 W Grand Ave
Prt Washingtn, WI 53074
Phone (262) 268-6998

13111 N Port Washington Rd
Thiensville, WI 53097
Phone (262) 243-7300

801 S 70th St
West Allis, WI 53214
Phone (414) 773-6600

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": "1149379200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1339459200000",
    "number": "1245278852",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4425 N PORT WASHINGTON RD",
            "address_2": "ATTN: CSMCP CLINIC CREDENTIALING",
            "city": "GLENDALE",
            "state": "WI",
            "postal_code": "532121082",
            "telephone_number": "414-271-1633",
            "fax_number": "414-271-5071"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2350 N LAKE DR",
            "address_2": "SUITE 400",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532114528",
            "telephone_number": "414-271-1633",
            "fax_number": "414-271-5071"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATHEW",
        "first_name": "JAMES",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-04",
        "last_updated": "2012-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "WI",
            "license": "45947",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "34446900",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

Verify at the official NPI Registry.