Kandathil M. Mathew, M.D.

Primary specialty

Cardiovascular Disease PhysicianTaxonomy code 207RC0000X

License

021547 Issued in GA

Practice address

6507 Professional PL
Riverdale, GA 30274-4941

Phone

(770) 991-2100

Fax

(770) 991-1180

NPI assigned

Apr 10, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in GA

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 1

Specialty

Cardiovascular Disease (Cardiology)Also: Internal Medicine

Education

Other, 1969

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

The Emory Clinic IncGroup PAC ID 8820901408, 3,507 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Emory University Hospital Midtown Hospital, Atlanta, GA, CCN 110078

Merit-based Incentive Payment System (MIPS)

Final score

94.51 of 100Reported as apm

Quality

80.61

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kmathew19842@direct.emory.org

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• The Emory Clinic Inc

  • Internal Medicine Physician
  • Atlanta, GA
  • NPI 1396798229

  Cardiovascular Disease

  Medicare reassignment Care Compare group NPD
• Emory Specialty Associates, LLC

  • Anesthesiology Physician
  • Lagrange, GA
  • NPI 1407864168
  Medicare reassignment NPD
• Piedmont Henry Hospital, Inc.

  • General Acute Care Hospital
  • Stockbridge, GA
  • NPI 1225034333
  Medicare reassignment
• Emory Health Care

  • Neurology Physician
  • Atlanta, GA
  • NPI 1376642751
  NPD (past)
• Southern Regional Health System, Inc

  dba Southern Regional Medical Center

  • General Acute Care Hospital
  • Riverdale, GA
  • NPI 1831190958
  NPD (past)
• Southern Regional Physicians Management Group, LLC

  • Surgery Physician
  • Riverdale, GA
  • NPI 1043677271
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Crawford Long Hospital

  dba Emory University dba Emory Crawford Long Hospital

  • General Acute Care Hospital
  • Atlanta, GA
  • NPI 1144203563
  Care Compare affiliation

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

{
    "created_epoch": "1144627200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1203897600000",
    "number": "1265495444",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6507 PROFESSIONAL PL",
            "city": "RIVERDALE",
            "state": "GA",
            "postal_code": "302744941",
            "telephone_number": "770-991-2100",
            "fax_number": "770-991-1180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6507 PROFESSIONAL PL",
            "city": "RIVERDALE",
            "state": "GA",
            "postal_code": "302744941",
            "telephone_number": "770-991-2100",
            "fax_number": "770-991-1180"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATHEW",
        "first_name": "KANDATHIL",
        "middle_name": "M.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-10",
        "last_updated": "2008-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "GA",
            "license": "021547",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00294698A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Alexis R Marshall
• Carolyn W. Marshall, L.C.S.W., ED. S.
• Megan Marshall, MD
• David Michael Martin, MD
• Jacquelyn Hairston Martin, C-FNP
• Lauren Ashley Mattox, PMHNP
• Maxicare Medical Supply
• Sharlene Maynor, NP
• Efiong E. Mbaba, REGISTERED NURSE
• Dominique Mary McCray

• Cardiovascular Disease Physician in Riverdale, GA
• Providers in Riverdale, GA by specialty
• Cardiovascular Disease Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.