Active NPI
Renu Mathews
- Pediatrics Physician
- Stockton, CA
National Provider Identifier
1255642641
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- C52600
- Practice address
- 1240 W Robinhood Dr
Suite G
Stockton, CA 95207-5507 - Phone
- (209) 472-1470
- Fax
- (209) 472-1961
- NPI assigned
- Jun 30, 2010
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | C52600 | CA | Primary |
Addresses
Primary practice location
1240 W Robinhood Dr
Suite G
Stockton, CA 95207-5507
Mailing address
1240 W Robinhood Dr
Suite G
Stockton, CA 95207-5507
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
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| C52600 | CA | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Hill Physicians Medical Group - PPO Program | Past | Accepting new patients | |
| Pediatric Care of Stockton | Pediatrics | Past | Accepting new patients |
| Hill Physicians Care Solutions, Inc. | Past | Accepting new patients |
Networks
- BSC 65 PLUS INDIVIDUAL MAPD
Organizations & group practices 3
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.
-
- Health Maintenance Organization
- San Ramon, CA
- NPI 1437769429
-
- Preferred Provider Organization
- San Ramon, CA
- NPI 1679011035
-
- Pediatrics Physician
- Stockton, CA
- NPI 1790844769
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1277856000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1277856000000",
"number": "1255642641",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1240 W ROBINHOOD DR",
"address_2": "SUITE G",
"city": "STOCKTON",
"state": "CA",
"postal_code": "952075507"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1240 W ROBINHOOD DR",
"address_2": "SUITE G",
"city": "STOCKTON",
"state": "CA",
"postal_code": "952075507",
"telephone_number": "209-472-1470",
"fax_number": "209-472-1961"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MATHEWS",
"first_name": "RENU",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-06-30",
"last_updated": "2010-06-30",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "CA",
"license": "C52600",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Stockton, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.