Individual provider Active NPI

Christy Varghese Mathew

  • Internal Medicine Physician
  • Massapequa, NY
National Provider Identifier
1316537079
Registry record updated Jan 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
F346083-01 Issued in NY
Practice address
808A Hicksville Rd
Massapequa, NY 11758-1262
Phone
(516) 597-4242
NPI assigned
Jan 26, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 26, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X F346083-01 NY Primary

Addresses

Primary practice location

808A Hicksville Rd
Massapequa, NY 11758-1262

Mailing address

2096 Prospect Ave
East Meadow, NY 11554-1902
Phone (516) 413-9055

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
F346083-01NYMDInternal Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1611619200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611619200000",
    "number": "1316537079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2096 PROSPECT AVE",
            "city": "EAST MEADOW",
            "state": "NY",
            "postal_code": "115541902",
            "telephone_number": "516-413-9055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "808A HICKSVILLE RD",
            "city": "MASSAPEQUA",
            "state": "NY",
            "postal_code": "117581262",
            "telephone_number": "516-597-4242"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATHEW",
        "first_name": "CHRISTY",
        "middle_name": "VARGHESE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-01-26",
        "last_updated": "2021-01-26",
        "certification_date": "2021-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "F346083-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Massapequa, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2021; 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.