Individual provider Active NPI

Trini A Mathew, MD

  • Infectious Disease Physician
  • Johnstown, PA
National Provider Identifier
1346288560
Registry record updated Jul 29, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infectious Disease PhysicianTaxonomy code 207RI0200X
License
048405 Issued in CT
Practice address
1086 Franklin St
Johnstown, PA 15905-4305
Phone
(814) 534-3386
Fax
(814) 410-8331
NPI assigned
Jun 2, 2006
Last updated
Jul 29, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Infectious Disease Physician 207RI0200X 048405 CT Primary

Addresses

Primary practice location

1086 Franklin St
Johnstown, PA 15905-4305

Mailing address

1086 Franklin St
Johnstown, PA 15905-4305
Phone (814) 410-8300

Other identifiers 1

IdentifierTypeStateIssuer
1346288560MedicaidCT

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171109002052 MI Practitioner - Infectious Disease 3072608850 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Infectious Disease
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

28100 Grand River Ave
Farmington Hills, MI 48336-5970

3601 W 13 Mile Rd
Royal Oak, MI 48073-6712

3601 W 13 Mile Rd Ec
Beaumont Emergency Services Ro
Royal Oak, MI 48073-6712
Phone (248) 898-5058

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Beaumont Medical Group- Specialty Services CurrentSince Mar 20, 2018 Accepting new patients
University Internal Medicine Assoc LLP Internal Medicine Past Accepting new patients

Locations

28100 Grand River Ave
Ste 301
Farmington Hills, MI 48336
Phone (947) 521-1320

3535 W 13 Mile Rd
Royal Oak, MI 48073
Phone (248) 551-1010

3601 W 13 Mile Rd
Royal Oak, MI 48073

Interoperability endpoints

  • Direct secure messaging: tmathew1245588@epic00.shdirect.org

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.

Hospital & facility affiliations 3

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

NPI Registry JSON

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

{
    "created_epoch": "1149206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1438128000000",
    "number": "1346288560",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1086 FRANKLIN ST",
            "city": "JOHNSTOWN",
            "state": "PA",
            "postal_code": "159054305",
            "telephone_number": "814-410-8300",
            "fax_number": "814-410-8331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1086 FRANKLIN ST",
            "city": "JOHNSTOWN",
            "state": "PA",
            "postal_code": "159054305",
            "telephone_number": "814-534-3386",
            "fax_number": "814-410-8331"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATHEW",
        "first_name": "TRINI",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-02",
        "last_updated": "2015-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "CT",
            "license": "048405",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1346288560",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Johnstown, PA

Sources for this page

Verify at the official NPI Registry.