Merrin Mathew

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

036153127 Issued in IL

Practice address

17800 Kedzie Ave
Hazel Crest, IL 60429-2029

Phone

(708) 213-4200

NPI assigned

Apr 11, 2016

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

Electronic endpoints 2

Medicare fee-for-service enrollment

Enrolled in TX

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

Emergency Medicine

Education

Nova Southeastern College of Osteo Medicine, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Ies Carrollton PLLCGroup PAC ID 2961830666, 5 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Medical City Plano Hospital, Plano, TX, CCN 450651

Merit-based Incentive Payment System (MIPS)

Final score

96.68 of 100Reported as group

Quality

89.15

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy, Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mmathew284262@direct.myadvocateaurora.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.

• Ies Carrollton PLLC

  • Emergency Medicine Physician
  • Carrollton, TX
  • NPI 1134769789
  Medicare reassignment Care Compare group NPD
• Century Integrated Partners, Inc

  • Emergency Medicine Physician
  • Dallas, TX
  • NPI 1447615711
  Medicare reassignment NPD
• Concord Medical Group PLLC

  • Emergency Medicine Physician
  • Lubbock, TX
  • NPI 1083630610
  Medicare reassignment NPD
• Questcare Medical Services, PLLC

  • Emergency Medicine Physician
  • Dallas, TX
  • NPI 1912059247
  Medicare reassignment NPD
• Concord Medical Group of Texas PLLC

  • Emergency Medicine Physician
  • Lubbock, TX
  • NPI 1750790762
  NPD
• Questcare Medical Services PLLC

  • Emergency Medicine Physician
  • Plano, TX
  • NPI 1164574489
  NPD
• Questcare Medical Services, PLLC

  • Nurse Practitioner
  • Arlington, TX
  • NPI 1497807713

  Emergency Medicine

  NPD

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

• Columbia Medical Center of Plano Subsidiary LP

  • General Acute Care Hospital
  • Plano, TX
  • NPI 1699726406
  Care Compare affiliation

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

{
    "created_epoch": "1460332800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651190400000",
    "number": "1275997652",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29373 NETWORK PL",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606731293"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17800 KEDZIE AVE",
            "city": "HAZEL CREST",
            "state": "IL",
            "postal_code": "604292029",
            "telephone_number": "708-213-4200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATHEW",
        "first_name": "MERRIN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-04-11",
        "last_updated": "2022-04-29",
        "certification_date": "2022-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IL",
            "license": "036153127",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "17800 Kedzie Ave",
            "city": "Hazel Crest",
            "state": "IL",
            "country_code": "US",
            "postal_code": "604292029",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mmathew284262@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "17800 Kedzie Ave",
            "city": "Hazel Crest",
            "state": "IL",
            "country_code": "US",
            "postal_code": "604292029",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Marie A Mance, RN
• Manna for Life Services, LLC
• Volodimir Z Markiv, MD
• Martin R Hall MD. SC.
• Jill M. Martinez
• Mariah Erin Taylor McCaskill
• Theresa Marie McCollom, PTA
• Randolph M McConnie, MD
• Stavone McHerron
• Dawn Faith McKenzie-Brown

• Emergency Medicine Physician in Hazel Crest, IL
• Providers in Hazel Crest, IL by specialty
• Emergency Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2022; 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.