Individual provider Active NPI

Mathew Sabu, PHARM.D.

  • Pharmacist
  • Somerset, NJ
National Provider Identifier
1265037212
Registry record updated Nov 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
28RI03805700 Issued in NJ
Practice address
462 Elizabeth Ave
Somerset, NJ 08873-5107
Phone
(516) 849-5801
NPI assigned
Nov 30, 2020
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 30, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 28RI03805700 NJ Primary

Addresses

Primary practice location

462 Elizabeth Ave
Somerset, NJ 08873-5107

Mailing address

870 Kallas CT
Valley Stream, NY 11580-1517
Phone (516) 849-5801

Other identifiers 2

IdentifierTypeStateIssuer
064685OtherNYLICENSE
28RI03805700OtherNJLICENSE

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 Pharmacy

State licenses

LicenseStateTypeSpecialty
28RI03805700NJMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1606694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606694400000",
    "number": "1265037212",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "870 KALLAS CT",
            "city": "VALLEY STREAM",
            "state": "NY",
            "postal_code": "115801517",
            "telephone_number": "516-849-5801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "462 ELIZABETH AVE",
            "city": "SOMERSET",
            "state": "NJ",
            "postal_code": "088735107",
            "telephone_number": "516-849-5801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SABU",
        "first_name": "MATHEW",
        "name_prefix": "Dr.",
        "credential": "PHARM.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-11-30",
        "last_updated": "2020-11-30",
        "certification_date": "2020-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NJ",
            "license": "28RI03805700",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "064685",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "28RI03805700",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Somerset, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2020; 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.