Individual provider Active NPI

Jeremy Mathenia, PA-C

  • Medical Physician Assistant
  • St Thomas, VI
National Provider Identifier
1285910059
Registry record updated Aug 11, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
105 Issued in VI
Practice address
6500 Red Hook PLZ Ste 205
St Thomas, VI 00802-1346
Phone
(340) 775-2303
NPI assigned
Oct 25, 2011
Last updated
Aug 11, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2026

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 085-004144 IL
Medical Physician Assistant 363AM0700X 085004144 IL
Medical Physician Assistant 363AM0700X VI
Medical Physician Assistant 363AM0700X 105 VI Primary

Addresses

Primary practice location

6500 Red Hook PLZ Ste 205
St Thomas, VI 00802-1346

Mailing address

6500 Red Hook PLZ Ste 205
St Thomas, VI 00802-1346
Phone (340) 775-2303

Other practice location 1

1001 Health Center Dr
Mattoon, IL 61938-4693
Phone (217) 258-2250

Other practice location 2

160 Hollywood Dr
Butler, PA 16001-5600
Phone (724) 282-6175

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250417001389 VI Practitioner - Physician Assistant 2769656297 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Red Hook Family Practice P.C.Group PAC ID 5496978363, 7 clinicians

Practice addresses (Care Compare)

6500 Red Hook PLZ
Suite 205
St Thomas, VI 00802-1346
Phone (340) 775-2303

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
79.53 of 100Reported as group
Quality
73.42
Promoting interoperability
100
Improvement activities
40
Cost
47.86

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
085-004144ILMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Yacht Haven Family Practice Past Accepting new patients

Organizations & group practices 2

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1319500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786406400000",
    "number": "1285910059",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6500 RED HOOK PLZ STE 205",
            "city": "ST THOMAS",
            "state": "VI",
            "postal_code": "008021346",
            "telephone_number": "340-775-2303"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6500 RED HOOK PLZ STE 205",
            "city": "ST THOMAS",
            "state": "VI",
            "postal_code": "008021346",
            "telephone_number": "340-775-2303"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1001 Health Center Dr",
            "address_purpose": "LOCATION",
            "city": "Mattoon",
            "state": "IL",
            "postal_code": "619384693",
            "country_code": "US",
            "telephone_number": "217-258-2250",
            "fax_number": "217-258-2249",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "160 Hollywood Dr",
            "address_purpose": "LOCATION",
            "city": "Butler",
            "state": "PA",
            "postal_code": "160015600",
            "country_code": "US",
            "telephone_number": "724-282-6175",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MATHENIA",
        "first_name": "JEREMY",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-10-25",
        "last_updated": "2026-08-11",
        "certification_date": "2026-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085-004144",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "IL",
            "license": "085004144",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "VI",
            "license": null,
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "VI",
            "license": "105",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St Thomas, VI

Sources for this page

Verify at the official NPI Registry.