Individual provider Active NPI

Manoj Mathew, MD

  • Aerospace Medicine Physician
  • Fort George G Meade, MD
National Provider Identifier
1346535838
Registry record updated Apr 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Aerospace Medicine PhysicianTaxonomy code 2083A0100X
License
59999-20 Issued in WI
Practice address
9800 Savage Rd
Fort George G Meade, MD 20755-5999
Phone
(443) 479-0353
NPI assigned
Jun 13, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 29, 2026

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

Specialties & licenses 11

Specialty (taxonomy)CodeLicenseStatePrimary
Diabetology (Internal Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207QB0505X D0105915 MD
Preventive Medicine/Occupational Environmental Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2083P0500X D0105915 MD
Aerospace Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2083A0100X D0105915 MD
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X D0105915 MD
General Practice PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208D00000X D0105915 MD
Internal Medicine Physician 207R00000X 5999-20 WI
Preventive Medicine/Occupational Environmental Medicine Physician 2083P0500X 59999-20 WI
Primary Care Clinic/Center 261QP2300X 59999-20 WI
Aerospace Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2083A0100X 59999-20 WI Primary
Military Health Care Provider 171000000X 59999-20 WI
Military Health Care ProviderGroup: 193200000X MULTI-SPECIALTY GROUP 171000000X D0105915 MD

Addresses

Primary practice location

9800 Savage Rd
Fort George G Meade, MD 20755-5999

Mailing address

11500 Alcinda LN
North Potomac, MD 20878-2427
Phone (713) 530-8665

Other practice location 1

21044 Frederick Rd
Germantown, MD 20876-4132
Phone (240) 238-5432

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address MDExchange@patientfirst.com Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD, DC, WI, VA, TX, PA6 enrollments
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 6

Enrollment IDStateProvider typePAC IDDetails
I20260424001117 MD Practitioner - Preventive Medicine 4082181250 Reassigns benefits to 3 organizations
I20260424001382 DC Practitioner - Preventive Medicine 4082181250 Reassigns benefits to 2 organizations
I20260505000860 WI Practitioner - Preventive Medicine 4082181250 Reassigns benefits to 1 organization
I20260505003081 VA Practitioner - Preventive Medicine 4082181250 Reassigns benefits to 1 organization
I20260506003063 TX Practitioner - Preventive Medicine 4082181250 Reassigns benefits to 1 organization
I20260507003236 PA Practitioner - Preventive Medicine 4082181250 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Preventive Medicine
Education
Other, 2001
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

11500 Alcinda LN
North Potomac, MD 20878-2427

4055 Valley View LN
Suite 700
Dallas, TX 75244-4910

5000 Cox Rd
Glen Allen, VA 23060-9263

5080 Spectrum Dr
Suite 1200W
Addison, TX 75001-6443

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
D0105915MDMDMilitary Health Care Provider
5999-20WIMDInternal Medicine Physician
59999-20WIMDPreventive Medicine/Occupational Environmental Medicine Physician

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": "1307923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1777420800000",
    "number": "1346535838",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11500 ALCINDA LN",
            "city": "NORTH POTOMAC",
            "state": "MD",
            "postal_code": "208782427",
            "telephone_number": "713-530-8665"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9800 SAVAGE RD",
            "city": "FORT GEORGE G MEADE",
            "state": "MD",
            "postal_code": "207555999",
            "telephone_number": "443-479-0353"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "21044 Frederick Rd",
            "address_purpose": "LOCATION",
            "city": "Germantown",
            "state": "MD",
            "postal_code": "208764132",
            "country_code": "US",
            "telephone_number": "240-238-5432",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MATHEW",
        "first_name": "MANOJ",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-06-13",
        "last_updated": "2026-04-29",
        "certification_date": "2026-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QB0505X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Diabetology",
            "state": "MD",
            "license": "D0105915",
            "primary": false
        },
        {
            "code": "2083P0500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Preventive Medicine, Preventive Medicine/Occupational Environmental Medicine",
            "state": "MD",
            "license": "D0105915",
            "primary": false
        },
        {
            "code": "2083A0100X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Preventive Medicine, Aerospace Medicine",
            "state": "MD",
            "license": "D0105915",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "MD",
            "license": "D0105915",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": "MD",
            "license": "D0105915",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WI",
            "license": "5999-20",
            "primary": false
        },
        {
            "code": "2083P0500X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Preventive Medicine/Occupational Environmental Medicine",
            "state": "WI",
            "license": "59999-20",
            "primary": false
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "WI",
            "license": "59999-20",
            "primary": false
        },
        {
            "code": "2083A0100X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Preventive Medicine, Aerospace Medicine",
            "state": "WI",
            "license": "59999-20",
            "primary": true
        },
        {
            "code": "171000000X",
            "taxonomy_group": "",
            "desc": "Military Health Care Provider",
            "state": "WI",
            "license": "59999-20",
            "primary": false
        },
        {
            "code": "171000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Military Health Care Provider",
            "state": "MD",
            "license": "D0105915",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "MDExchange@patientfirst.com",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "21044 Frederick Rd",
            "city": "Germantown",
            "state": "MD",
            "country_code": "US",
            "postal_code": "208764132",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Fort George G Meade, MD

Sources for this page

Verify at the official NPI Registry.