Alex Mathew Jr.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

MT217168 Issued in PA

Practice address

30 N 4TH St
Lebanon, PA 17046-5606

Phone

(717) 270-1949

NPI assigned

Jan 21, 2019

Last updated

Dec 13, 2021By the provider in NPPES

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

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in NY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Hospitalist

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Samaritan Hospital of Troy, New YorkGroup PAC ID 6507770070, 258 clinicians

St Peters Hospital of the City of AlbanyGroup PAC ID 2668460072, 268 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Community Hospice, Inc, the Hospice, Albany, NY, CCN 331501
• St Peter's Hospital Hospital, Albany, NY, CCN 330057
• Samaritan Hospital of Troy, New York Hospital, Troy, NY, CCN 330180

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Samaritan Hospital of Troy, New York

  • General Acute Care Hospital
  • Troy, NY
  • NPI 1043267727

  Family Medicine

  Medicare reassignment Care Compare group NPD
• St. Peter's Hospital of the City of Albany

  dba St. Peter's Hospital

  • General Acute Care Hospital
  • Albany, NY
  • NPI 1518042357

  Family Medicine

  Medicare reassignment Care Compare group NPD
• St. Peter's Hospital of the City of Albany

  • General Acute Care Hospital
  • Albany, NY
  • NPI 1497701106

  Family Medicine

  NPD

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

• Samaritan Hospital of Troy, New York

  • General Acute Care Hospital
  • Troy, NY
  • NPI 1043267727
  Care Compare affiliation
• St. Peter's Hospital of the City of Albany

  • General Acute Care Hospital
  • Albany, NY
  • NPI 1497701106
  Care Compare affiliation
• The Community Hospice Inc

  • Community Based Hospice Care Agency
  • Albany, NY
  • NPI 1588631733
  Care Compare affiliation

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

{
    "created_epoch": "1548028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639353600000",
    "number": "1306310644",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 N 4TH ST",
            "city": "LEBANON",
            "state": "PA",
            "postal_code": "170465606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 N 4TH ST",
            "city": "LEBANON",
            "state": "PA",
            "postal_code": "170465606",
            "telephone_number": "717-270-1949"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "315 S Manning Blvd",
            "address_purpose": "LOCATION",
            "city": "Albany",
            "state": "NY",
            "postal_code": "122081707",
            "country_code": "US",
            "telephone_number": "518-525-1550",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2215 Burdett Ave",
            "address_purpose": "LOCATION",
            "city": "Troy",
            "state": "NY",
            "postal_code": "121802466",
            "country_code": "US",
            "telephone_number": "518-271-3300",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MATHEW",
        "first_name": "ALEX",
        "name_suffix": "Jr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-01-21",
        "last_updated": "2021-12-13",
        "certification_date": "2021-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "NY",
            "license": "313748",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "MT217168",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "payer.credentialing@sphp.com",
            "affiliation": "N",
            "endpointDescription": "SPHP Payer Credentialing",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "315 S Manning Blvd",
            "city": "Albany",
            "state": "NY",
            "country_code": "US",
            "postal_code": "122081707",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Jennifer Mae Martin, FNP-C
• Jessica Martin
• Keturah Martin, LMFT
• Yamisel Martinez-Molina, LPC
• James V Mascoli, O.D.
• Jennifer Elizabeth Matlack, OTR/L
• Kathleen Mattes-Longo, CRNA
• Carol N. Maurer
• Elaine S Maurer
• Savas Mavridis, MD

• Family Medicine Physician in Lebanon, PA
• Providers in Lebanon, PA by specialty
• Family Medicine Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2021; 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.