Individual provider Active NPI

Jessey Mathew, FNP

  • Family Medicine Physician
  • Forney, TX
National Provider Identifier
1356957153
Registry record updated Aug 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
AP143810 Issued in TX
Practice address
763 E US Highway 80 Ste 240
Forney, TX 75126-8677
Phone
(469) 800-3870
Fax
(469) 800-3880
NPI assigned
Sep 17, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 15, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X AP143810 TX Primary

Addresses

Primary practice location

763 E US Highway 80 Ste 240
Forney, TX 75126-8677

Mailing address

763 E US Highway 80 Ste 240
Forney, TX 75126-8677
Phone (469) 800-3870

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210201002590 TX Practitioner - Nurse Practitioner 9830503929 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Healthtexas Provider NetworkGroup PAC ID 1355254210, 2,535 clinicians

Practice addresses (Care Compare)

821 N Coleman St
Suite 100
Prosper, TX 75078-2339
Phone (469) 800-5200

Hospital & facility affiliations

  • Baylor Scott and White Medical Center Lake Pointe Hospital, Rowlett, TX, CCN 450742

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Healthtexas Provider Network Multi-Specialty Current Accepting new patients
Little Lantern Clinic LLC Multi-Specialty CurrentSince Oct 8, 2020 Accepting new patients
Healthtexas Provider Network Multi-Specialty CurrentSince Jul 25, 2022 Accepting new patients
Healthtexas Provider Network Multi-Specialty CurrentSince Jul 25, 2022 Accepting new patients

Locations

4541 N Josey Ln
Ste 110
Carrollton, TX 75010
Phone (469) 775-9555

4001 Worth St
#A
Dallas, TX 75246
Phone (214) 820-8665

9 Medical Pkwy
Ste 210
Farmers Branch, TX 75234
Phone (214) 449-6511

763 E US Highway 80
Ste 240
Forney, TX 75126
Phone (469) 689-0100

821 N Coleman St
Ste 100
Prosper, TX 75078
Phone (469) 800-5200

Interoperability endpoints

  • Direct secure messaging: jmathew494062@direct.sw.org

Organizations & group practices 4

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 1

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": "1600300800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692057600000",
    "number": "1356957153",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "763 E US HIGHWAY 80 STE 240",
            "city": "FORNEY",
            "state": "TX",
            "postal_code": "751268677",
            "telephone_number": "469-800-3870",
            "fax_number": "469-800-3880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "763 E US HIGHWAY 80 STE 240",
            "city": "FORNEY",
            "state": "TX",
            "postal_code": "751268677",
            "telephone_number": "469-800-3870",
            "fax_number": "469-800-3880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATHEW",
        "first_name": "JESSEY",
        "name_prefix": "Ms.",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-09-17",
        "last_updated": "2023-08-15",
        "certification_date": "2023-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "AP143810",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Forney, TX

Sources for this page

Verify at the official NPI Registry.