Individual provider Active NPI

Krishan Mathur, M.D.

  • Hematology & Oncology Physician
  • Waldorf, MD
National Provider Identifier
1326082884
Registry record updated Nov 30, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
License
D28352 Issued in MD
Practice address
3500 Old Washington Rd
Suite 102
Waldorf, MD 20602-3224
Phone
(301) 645-4242
Fax
(301) 705-7512
NPI assigned
Jun 15, 2006
Last updated
Nov 30, 2010By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 30, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology & Oncology Physician 207RH0003X D28352 MD Primary

Addresses

Primary practice location

3500 Old Washington Rd
Suite 102
Waldorf, MD 20602-3224

Mailing address

PO Box 2729
La Plata, MD 20646-2729
Phone (301) 645-4242

Other identifiers 5

IdentifierTypeStateIssuer
301331600MedicaidMD
3600310OtherUHC
38917OtherMAMSI
35150501OtherCAREFIRST BC BS
4376960OtherAETNA

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)
Enrolled
Credentials
Doctor of Medicine

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1150329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1291075200000",
    "number": "1326082884",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2729",
            "city": "LA PLATA",
            "state": "MD",
            "postal_code": "206462729",
            "telephone_number": "301-645-4242",
            "fax_number": "301-705-7512"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3500 OLD WASHINGTON RD",
            "address_2": "SUITE 102",
            "city": "WALDORF",
            "state": "MD",
            "postal_code": "206023224",
            "telephone_number": "301-645-4242",
            "fax_number": "301-705-7512"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATHUR",
        "first_name": "KRISHAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-15",
        "last_updated": "2010-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "MD",
            "license": "D28352",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "301331600",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UHC",
            "identifier": "3600310",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAMSI",
            "identifier": "38917",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREFIRST BC BS",
            "identifier": "35150501",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "4376960",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Waldorf, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2010; 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.