Mary Ellen Mathe, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA9104653 Issued in FL

Practice address

1812 N Mills Ave
Orlando, FL 32803-1870

Phone

(407) 897-3499

Fax

(407) 894-8746

NPI assigned

Jun 5, 2006

Sex

Female

Sole proprietor

No

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Interoperability endpoints

• Direct secure messaging: mmathe118707@direct.nemours.org

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

{
    "created_epoch": "1149465600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1428019200000",
    "number": "1245279520",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1812 N MILLS AVE",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328031870",
            "telephone_number": "407-897-3499",
            "fax_number": "407-894-8746"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1812 N MILLS AVE",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328031870",
            "telephone_number": "407-897-3499",
            "fax_number": "407-894-8746"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATHE",
        "first_name": "MARY",
        "middle_name": "ELLEN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-05",
        "last_updated": "2015-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "009409",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9104653",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mariela Mateo
• Ricardo Luis Mateo, RRT
• Maternity Mentor, Inc
• Leslie Dionne Matesick, DO
• Beena Joseph Mathai, B.S IN PHARMACY
• Jeanine Mathelier
• Clyde Mathes
• Virgilio Matheus, M.D.
• Bijitha Mathew
• Nishamol Mathew, FNP-C

• Physician Assistant in Orlando, FL
• Providers in Orlando, FL by specialty
• Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2015; 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.