Individual provider Active NPI

Rohit Varghese Mathew, PA-C

  • Physician Assistant
  • Hillsboro, OR
National Provider Identifier
1295013076
Registry record updated Sep 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA201332 Issued in OR
Practice address
10670 NE Cornell Rd Ste 101
Hillsboro, OR 97124-9221
Phone
(503) 216-9360
NPI assigned
Jul 28, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 2374 OK
Physician Assistant 363A00000X PA201332 OR Primary

Addresses

Primary practice location

10670 NE Cornell Rd Ste 101
Hillsboro, OR 97124-9221

Mailing address

PO Box 3158
Portland, OR 97208-3158
Phone (503) 215-6494

Other practice location 1

1651 Professional Cir
Yukon, OK 73099-6314
Phone (405) 350-6770

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address rmathew1393357@oc.providencedirect.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
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
I20201020002694 OR Practitioner - Physician Assistant 2163696899 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

Practice addresses (Care Compare)

10670 NE Cornell Rd
Hillsboro, OR 97124-9221

12442 SW Scholls Ferry Rd
Suite 100
Tigard, OR 97223-0803
Phone (503) 215-9900

1321 NE 99TH Ave
Suite 100
Portland, OR 97220-9437
Phone (503) 215-9900

1321 NE 99TH Ave
Suite 200
Portland, OR 97220-9439
Phone (503) 215-4250

16770 SW Edy Rd
Suite 102
Sherwood, OR 97140-9679
Phone (503) 216-9600

200 S Hazel Dell Way
Canby, OR 97013-7829
Phone (203) 263-9500

5050 NE Hoyt St
Suite 240
Portland, OR 97213-2981
Phone (503) 215-6480

5050 NE Hoyt St
Suite 454
Portland, OR 97213-2984
Phone (503) 215-6405

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
014882NYMDPhysical Therapy Assistant
PA201332ORMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Health & Services Oregon Current Accepting new patients
Providence Health & Services - Oregon CurrentSince Oct 1, 2020 Accepting new patients
Summit Medical Center Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: rmathew1393357@oc.providencedirect.org

Organizations & group practices 3

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.

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": "1311811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631836800000",
    "number": "1295013076",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3158",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972083158",
            "telephone_number": "503-215-6494"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10670 NE CORNELL RD STE 101",
            "city": "HILLSBORO",
            "state": "OR",
            "postal_code": "971249221",
            "telephone_number": "503-216-9360"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1651 Professional Cir",
            "address_purpose": "LOCATION",
            "city": "Yukon",
            "state": "OK",
            "postal_code": "730996314",
            "country_code": "US",
            "telephone_number": "405-350-6770",
            "fax_number": "405-350-6768",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MATHEW",
        "first_name": "ROHIT",
        "middle_name": "VARGHESE",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-07-28",
        "last_updated": "2021-09-17",
        "certification_date": "2021-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OK",
            "license": "2374",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OR",
            "license": "PA201332",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rmathew1393357@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "10670 NE Cornell Rd Ste 204",
            "city": "Hillsboro",
            "state": "OR",
            "country_code": "US",
            "postal_code": "971249221",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Hillsboro, OR

Sources for this page

Verify at the official NPI Registry.