Individual provider Active NPI

Mathai Palamattathil

  • Pharmacist
  • Naples, FL
National Provider Identifier
1295335628
Registry record updated Oct 26, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PS40278 Issued in FL
Practice address
11225 Tamiami TRL N
Naples, FL 34110-1639
Phone
(239) 591-3727
NPI assigned
Oct 26, 2020
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 26, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X PS40278 FL Primary

Addresses

Primary practice location

11225 Tamiami TRL N
Naples, FL 34110-1639

Mailing address

6588 Dabney St
Fort Myers, FL 33966-1100
Phone (239) 823-1996

Other practice location 1

11225 Tamiami Trl N
Naples, FL 34110-1639
Phone (239) 591-3727

Other practice location 2

11225 Tamiami Trl N
Naples, FL 34110-1639
Phone (239) 591-3727

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
PS40278FLMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1603670400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603670400000",
    "number": "1295335628",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6588 DABNEY ST",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339661100",
            "telephone_number": "239-823-1996"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11225 TAMIAMI TRL N",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "341101639",
            "telephone_number": "239-591-3727"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11225 Tamiami Trl N",
            "address_purpose": "LOCATION",
            "city": "Naples",
            "state": "FL",
            "postal_code": "341101639",
            "country_code": "US",
            "telephone_number": "239-591-3727",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "11225 Tamiami Trl N",
            "address_purpose": "LOCATION",
            "city": "Naples",
            "state": "FL",
            "postal_code": "341101639",
            "country_code": "US",
            "telephone_number": "239-591-3727",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PALAMATTATHIL",
        "first_name": "MATHAI",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-10-26",
        "last_updated": "2020-10-26",
        "certification_date": "2020-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "FL",
            "license": "PS40278",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Naples, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.