Individual provider Active NPI

Jeffin P Mathew, D.O.

  • Internal Medicine Physician
  • Hackensack, NJ
National Provider Identifier
1346771599
Registry record updated May 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
25MB10903300 Issued in NJ
Practice address
30 Prospect Ave
Hackensack, NJ 07601-1915
Phone
(551) 996-4466
NPI assigned
Mar 21, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 23, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 25MB10903300 NJ Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

30 Prospect Ave
Hackensack, NJ 07601-1915

Mailing address

30 Prospect Ave
Hackensack, NJ 07601-1915
Phone (551) 996-4466

Other practice location 1

99 Beauvoir Avenue
Summit, NJ 07901-1915
Phone (908) 522-6414

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20200901003170 NJ Practitioner - Internal Medicine 4486071792 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
New York College of Osteo Medicine of New York Institute of Technology, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Rwjbh Emergency Medicine Associates, LLCGroup PAC ID 0941612840, 826 clinicians
Practice Associates Medical GroupGroup PAC ID 5890703177, 1,412 clinicians

Practice addresses (Care Compare)

201 Lyons Ave
Newark, NJ 07112-2027
Phone (973) 926-7000

225 Williamson St
Elizabeth, NJ 07202-3625
Phone (908) 994-5422

30 Prospect Ave
Hackensack, NJ 07601-1915
Phone (551) 996-5045

99 Beauvoir Ave
Summit, NJ 07902-3533
Phone (908) 522-2000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MB10903300NJMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Rwjbh Emergency Medicine Associates, LLC Internal Medicine CurrentSince Nov 30, 2020 Accepting new patients
Hackensack Meridian Health Medical Group - Primary Care PC Internal Medicine CurrentSince Oct 29, 2025 Accepting new patients
Hackensack Meridian Health Medical Group - Specialty Care PC Internal Medicine CurrentSince May 17, 2022 Accepting new patients
Hackensack Meridian Health Medical Group - Specialty Care PC CurrentSince May 17, 2022 Accepting new patients
Rwjbh Observation Associates LLC Internal Medicine CurrentSince Jan 19, 2022 Accepting new patients
Practice Associates Medical Group Internal Medicine CurrentSince Apr 6, 2024 Accepting new patients
Newark Beth Israel Medical Center Inc Past Accepting new patients
Meridian Medical Group - Specialty Care, PC Internal Medicine Past Accepting new patients

Locations

225 Williamson St
Elizabeth, NJ 07202
Phone (908) 994-5204

30 Prospect Ave
Hackensack, NJ 07601
Phone (201) 488-0066

600 River Ave
Lakewood, NJ 08701
Phone (732) 363-1900

100 Madison Ave
Morristown, NJ 07960
Phone (973) 538-5210

3600 State Route 66
Fl 3
Neptune City, NJ 07753
Phone (732) 807-0463

201 Lyons Ave
Newark, NJ 07112
Phone (732) 923-7455

201 Lyons Ave
#M
Newark, NJ 07112
Phone (800) 843-2384

300 Perrine Rd
Ste 324
Old Bridge, NJ 08857
Phone (732) 753-9890

110 Rehill Ave
Somerville, NJ 08876
Phone (908) 429-5833

99 Beauvoir Ave
Summit, NJ 07901
Phone (908) 522-2232

1 Hamilton Health Pl
Trenton, NJ 08690
Phone (609) 584-6763

Interoperability endpoints

  • FHIR API: https://mepic.hmhn.org/fhir/api/FHIR/R4/
  • FHIR API: https://fhir4.healow.com/fhir/r4/IHJHBD

Organizations & group practices 8

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.

Hospital & facility affiliations 4

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": "1490054400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716422400000",
    "number": "1346771599",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 PROSPECT AVE",
            "city": "HACKENSACK",
            "state": "NJ",
            "postal_code": "076011915",
            "telephone_number": "551-996-4466"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 PROSPECT AVE",
            "city": "HACKENSACK",
            "state": "NJ",
            "postal_code": "076011915",
            "telephone_number": "551-996-4466"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "99 Beauvoir Avenue",
            "address_purpose": "LOCATION",
            "city": "Summit",
            "state": "NJ",
            "postal_code": "079011915",
            "country_code": "US",
            "telephone_number": "908-522-6414",
            "fax_number": "908-598-2337",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MATHEW",
        "first_name": "JEFFIN",
        "middle_name": "P",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-03-21",
        "last_updated": "2024-05-23",
        "certification_date": "2024-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "25MB10903300",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hackensack, NJ

Sources for this page

Verify at the official NPI Registry.