Prakash Joel Mathew, MD, MBA

Primary specialty

Plastic Surgery PhysicianTaxonomy code 208200000X

License

MD473789 Issued in PA

Practice address

3400 Spruce St
Phildelphia, PA 19104-4206

Phone

(215) 662-2096

Fax

(215) 349-5895

NPI assigned

Aug 12, 2012

Last updated

Nov 4, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in PA, NJ2 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 2

Specialty

Plastic and Reconstructive Surgery

Education

Other, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Virtua Medical Group, PAGroup PAC ID 9830222397, 1,678 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• West Jersey Hospital Hospital, Voorhees, NJ, CCN 310022
• Virtua Mount Holly Hospital Hospital, Mount Holly, NJ, CCN 310057

Merit-based Incentive Payment System (MIPS)

Final score

81.15 of 100Reported as group

Quality

62.28

Promoting interoperability

100

Improvement activities

40

Cost

74.89

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Business Administration, Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: pmathew200259@directvirtua.org

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.

• Virtua Medical Group, PA

  • Family Medicine Physician
  • Marlton, NJ
  • NPI 1649226515

  Surgery

  Medicare reassignment Care Compare group NPD
• University of Penn-Medical Group

  • Gynecologic Oncology Physician
  • Philadelphia, PA
  • NPI 1235527342
  Medicare reassignment NPD
• University of Penn-Medical Group

  • Vascular Surgery Physician
  • Philadelphia, PA
  • NPI 1447648464
  NPD
• University of Penn-Medical Group

  • Surgical Oncology Physician
  • Philadelphia, PA
  • NPI 1871981985
  NPD
• Virtua Medical Group, PA

  dba Virtua Reconstructive Orthopedics - Delran

  • Orthopaedic Surgery Physician
  • Delran, NJ
  • NPI 1841087988
  NPD
• University of Penn - Medical Group

  • Cardiovascular Disease Physician
  • Philadelphia, PA
  • NPI 1093725145
  NPD (past)
• The Univeristy of Arizona

  • General Acute Care Hospital
  • Tucson, AZ
  • NPI 1952740151
  NPD (past)

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

• Virtua - Memorial Hospital Burlington County, Inc.

  dba Virtua Mount Holly Hospital

  • General Acute Care Hospital
  • Mount Holly, NJ
  • NPI 1134125016
  Care Compare affiliation
• Virtua - West Jersey Health System, Inc.

  • General Acute Care Hospital
  • Voorhees, NJ
  • NPI 1528064409
  Care Compare affiliation

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

{
    "created_epoch": "1344729600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730678400000",
    "number": "1356698013",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3400 SPRUCE ST",
            "city": "PHILDELPHIA",
            "state": "PA",
            "postal_code": "191044206",
            "telephone_number": "215-662-2096",
            "fax_number": "215-349-5895"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400 SPRUCE ST",
            "city": "PHILDELPHIA",
            "state": "PA",
            "postal_code": "191044206",
            "telephone_number": "215-662-2096",
            "fax_number": "215-349-5895"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1001 Route 73 N Uppr Levelb",
            "address_purpose": "LOCATION",
            "city": "Marlton",
            "state": "NJ",
            "postal_code": "080534524",
            "country_code": "US",
            "telephone_number": "856-355-7137",
            "fax_number": "856-355-7138",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MATHEW",
        "first_name": "PRAKASH",
        "middle_name": "JOEL",
        "name_prefix": "Dr.",
        "credential": "MD, MBA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-08-12",
        "last_updated": "2024-11-04",
        "certification_date": "2024-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "NJ",
            "license": "25MA11102600",
            "primary": false
        },
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "PA",
            "license": "MD473789",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0856983",
            "state": "NJ"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "pmathew200259@directvirtua.org",
            "affiliation": "N",
            "address_1": "1001 Route 73 N Uppr Levelb",
            "city": "Marlton",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "080534524",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Morgan Congdon, M.D.
• PHMC Immunization Program
• Latiana Ridgell, RN
• Mary Joy Daleno Rivero
• Kiara Smith

• Plastic Surgery Physician in Phildelphia, PA
• Providers in Phildelphia, PA by specialty
• Plastic Surgery Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.