Individual provider Active NPI

Selvi S Mathew, NP

  • Family Nurse Practitioner
  • White Plains, NY
National Provider Identifier
1316965510
Registry record updated Jan 14, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
26NJ00029300 Issued in NJ
Practice address
3 Barker Ave
4TH Floor
White Plains, NY 10601-1509
Phone
(914) 949-7900
Fax
(914) 949-1245
NPI assigned
Jul 17, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 14, 2009

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 333915 NY
Family Nurse Practitioner 363LF0000X 26NJ00029300 NJ Primary
Family Nurse Practitioner 363LF0000X NJ00029300NJ NJ

Addresses

Primary practice location

3 Barker Ave
4TH Floor
White Plains, NY 10601-1509

Mailing address

313 Shea Dr
New Milford, NJ 07646-1111
Phone (201) 599-9113

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ, NY2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20040505000909 NJ Practitioner - Nurse Practitioner 9133117310 Reassigns benefits to 1 organization
I20060825000227 NY Practitioner - Nurse Practitioner 9133117310 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
NJ00029300NJNJMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Tcprnc, LLC CurrentSince Jul 3, 2018 Accepting new patients
Tcprnc, LLC CurrentSince Jul 3, 2018 Accepting new patients
Hudson Hospital Opco LLC Current Accepting new patients
Garden State Healthcare Associates, LLC CurrentSince Jun 29, 2012 Accepting new patients
NP Care of NJ, LLC Past Accepting new patients
Park Avenue Medical Associates, P.C. PastSince Dec 4, 1999 Accepting new patients

Locations

308 Willow Ave
Hoboken, NJ 07030
Phone (201) 418-1574

176 Palisade Ave
Jersey City, NJ 07306
Phone (201) 795-8200

230 E Ridgewood Ave
Paramus, NJ 07652
Phone (201) 225-4700

100 W Kingsbridge Rd
Bronx, NY 10468
Phone (718) 410-1480

1000 Gates Ave
Ste 5
Brooklyn, NY 11221

Interoperability endpoints

  • Direct secure messaging: selvi.mathew@direct.christhospital.md

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1231891200000",
    "number": "1316965510",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "313 SHEA DR",
            "city": "NEW MILFORD",
            "state": "NJ",
            "postal_code": "076461111",
            "telephone_number": "201-599-9113",
            "fax_number": "914-949-1245"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 BARKER AVE",
            "address_2": "4TH FLOOR",
            "city": "WHITE PLAINS",
            "state": "NY",
            "postal_code": "106011509",
            "telephone_number": "914-949-7900",
            "fax_number": "914-949-1245"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATHEW",
        "first_name": "SELVI",
        "middle_name": "S",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-17",
        "last_updated": "2009-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "333915",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NJ",
            "license": "26NJ00029300",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NJ",
            "license": "NJ00029300NJ",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in White Plains, NY

Sources for this page

Verify at the official NPI Registry.