Active NPI
Gina Marie Mathew, MD
- Endocrinology, Diabetes & Metabolism Physician
- Mesa, AZ
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Endocrinology, Diabetes & Metabolism Physician
- License
- 52289
- Practice address
- 6424 E Broadway Rd Ste 105
Mesa, AZ 85206-1750 - Phone
- (623) 876-6960
- NPI assigned
- Mar 30, 2011
- Last updated
- Apr 23, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | NU | ||
| Endocrinology, Diabetes & Metabolism Physician | 207RE0101X | 52289 | AZ | Primary |
Addresses
Primary practice location
6424 E Broadway Rd Ste 105
Mesa, AZ 85206-1750
Mailing address
1917 S Crismon Rd
Mesa, AZ 85209-6216
Phone (623) 876-6960
Other practice location 1
4375 E Irma Ln
Phoenix, AZ 85050-4312
Phone (623) 876-6960
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in AZ
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Endocrinology
- Education
- University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 2011
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
1917 S Crismon Rd
Banner Health Center
Mesa, AZ 85209-6216
Phone (480) 610-7100
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 52289 | AZ | MD | Endocrinology, Diabetes & Metabolism Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Banner Physician Specialists Arizona LLC | Current | Accepting new patients | |
| Banner Physician Specialists Arizona LLC | Current | Accepting new patients | |
| Banner Physician Specialists Arizona LLC | Current | Accepting new patients | |
| VHS Outpatient Clinics, Inc. | Current | Accepting new patients | |
| VHS Outpatient Clinics, Inc. | Internal Medicine | Current | Accepting new patients |
Locations
5130 W Baseline Rd
Ste 102
Laveen, AZ 85339
Phone (602) 237-0039
1917 S Crismon Rd
Mesa, AZ 85209
Phone (480) 610-7100
6424 E Broadway Rd
Ste 105
Mesa, AZ 85206
Phone (480) 684-6487
9165 W Thunderbird Rd
Ste 200
Peoria, AZ 85381
Phone (623) 285-1120
2000 W Bethany Home Rd
Ste 200
Phoenix, AZ 85015
Phone (602) 246-5525
4375 E Irma Ln
Phoenix, AZ 85050
Phone (480) 890-5800
4524 N Maryvale Pkwy
Ste 220
Phoenix, AZ 85031
Phone (623) 535-4582
6036 N 19th Ave
Ste 505
Phoenix, AZ 85015
Phone (602) 249-0839
6036 N 19th Ave
Ste 506
Phoenix, AZ 85015
Phone (602) 246-5525
10401 W Thunderbird Blvd
Sun City, AZ 85351
Phone (623) 815-7690
Organizations & group practices 5
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.
-
- Multi-Specialty Clinic/Center
- Phoenix, AZ
- NPI 1821368218
-
dba Abrazo Medical Group
- Multi-Specialty Clinic/Center
- Goodyear, AZ
- NPI 1912979964
Internal Medicine
-
- Multi-Specialty Clinic/Center
- Phoenix, AZ
- NPI 1316228802
-
- Multi-Specialty Clinic/Center
- Page, AZ
- NPI 1366799355
-
dba Arizona Sports Medicine Center (ASMC)
- Durable Medical Equipment & Medical Supplies
- Scottsdale, AZ
- NPI 1891302790
Hospital & facility affiliations 3
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Phoenix, AZ
- NPI 1841224870
-
- General Acute Care Hospital
- Mesa, AZ
- NPI 1194758284
-
- General Acute Care Hospital
- Mesa, AZ
- NPI 1720011810
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1301443200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1713830400000",
"number": "1366731358",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1917 S CRISMON RD",
"city": "MESA",
"state": "AZ",
"postal_code": "852096216",
"telephone_number": "623-876-6960",
"fax_number": "623-285-2624"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6424 E BROADWAY RD STE 105",
"city": "MESA",
"state": "AZ",
"postal_code": "852061750",
"telephone_number": "623-876-6960"
}
],
"practiceLocations": [
{
"address_1": "4375 E Irma Ln",
"address_purpose": "LOCATION",
"city": "Phoenix",
"state": "AZ",
"postal_code": "850504312",
"country_code": "US",
"telephone_number": "623-876-6960",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MATHEW",
"first_name": "GINA",
"middle_name": "MARIE",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-03-30",
"last_updated": "2024-04-23",
"certification_date": "2024-04-23",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "NU",
"license": null,
"primary": false
},
{
"code": "207RE0101X",
"taxonomy_group": "",
"desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
"state": "AZ",
"license": "52289",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Mesa, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 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.