Jan E Mathisen, M.D.

Primary specialty

Neurology with Special Qualifications in Child Neurology PhysicianTaxonomy code 2084N0402X

License

11165 Issued in AL

Practice address

1940 Elmer J Bissell Rd
Suite C
Birmingham, AL 35243-2941

Phone

(205) 638-5860

Fax

(205) 638-5879

NPI assigned

Jan 22, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in AL

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

Pediatric Medicine

Education

Tulane University School of Medicine, 1982

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

University of Alabama Health Services Foundation, PCGroup PAC ID 1951213107, 2,784 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• The Children'S Hospital of Alabama Hospital, Birmingham, AL, CCN 013300
• Vaughan Regional Medical Center Parkway Campus Hospital, Selma, AL, CCN 010118

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• bcbs alabama network 01E0
• bcbs alabama network 01G0
• bcbs alabama network 01H0
• bcbs alabama network 01B0
• bcbs alabama network 01I0
• bcbs alabama network 01A0

Interoperability endpoints

• Direct secure messaging: jmathisen@direct.uabmedicine.org

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.

• University of Alabama Health Services Foundation, PC.

  • Multi-Specialty Clinic/Center
  • Birmingham, AL
  • NPI 1093768723
  Medicare reassignment Care Compare group NPD
• University of Alabama Health Services Foundation, PC

  • Pediatrics Physician
  • Birmingham, AL
  • NPI 1356377576
  NPD
• The Children'S Hospital of Alabama

  • Children's Hospital
  • Birmingham, AL
  • NPI 1205935012
  NPD (past)

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

• The Children'S Hospital of Alabama

  • Children's Hospital
  • Birmingham, AL
  • NPI 1205935012
  Care Compare affiliation
• Vaughan Regional Medical Center LLC

  • Rural Acute Care Hospital
  • Selma, AL
  • NPI 1871655993
  Care Compare affiliation

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

{
    "created_epoch": "1169424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1363824000000",
    "number": "1275687766",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1940 ELMER J BISSELL RD",
            "address_2": "SUITE C",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352432941",
            "telephone_number": "205-638-5860",
            "fax_number": "205-638-5879"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1940 ELMER J BISSELL RD",
            "address_2": "SUITE C",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352432941",
            "telephone_number": "205-638-5860",
            "fax_number": "205-638-5879"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATHISEN",
        "first_name": "JAN",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-22",
        "last_updated": "2013-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "AL",
            "license": "11165",
            "primary": false
        },
        {
            "code": "2084N0402X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology",
            "state": "AL",
            "license": "11165",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8804680",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "18033",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Morgan M Mathews, R.N
• Necia Mathews, LBA, BCBA
• Ronnie Mathews
• Winn Hutchinson Mathews, M.D.
• Meghan Rae Mathis, CRNP
• Mali Mathru, MD
• Taylor Mathwich
• Shelby Matier
• Heriberto Enrique Matos Santana, M.D.
• Yaricet Matos-Ramos, NP

• Neurology with Special Qualifications in Child Neurology Physician in Birmingham, AL
• Providers in Birmingham, AL by specialty
• Neurology with Special Qualifications in Child Neurology Physician in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2013; 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.