Individual provider Active NPI

Arun Deepak Mathur, MD

  • Family Medicine Physician
  • Sylvania, OH
National Provider Identifier
1376705822
Registry record updated May 18, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
35096157 Issued in OH
Practice address
5300 Harroun Rd
Suite 170
Sylvania, OH 43560-2182
Phone
(419) 824-1999
Fax
(419) 882-7016
NPI assigned
Jun 26, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 18, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 35096157 OH Primary

Addresses

Primary practice location

5300 Harroun Rd
Suite 170
Sylvania, OH 43560-2182

Mailing address

7640 Sylvania Ave
Ste K
Sylvania, OH 43560-9263
Phone (419) 824-1999

Other identifiers 1

IdentifierTypeStateIssuer
3154349MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20110628000758 OH Practitioner - Family PracticePractitioner - Sports Medicine 8224216916 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Sports Medicine
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Sylvan Lakes Family Physicians LTDGroup PAC ID 7416928460, 4 clinicians

Practice addresses (Care Compare)

7640 Sylvania Ave
Suite K
Sylvania, OH 43560-9263
Phone (419) 517-1001

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35096157OHMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sylvan Lakes Family Physicians LTD Family Medicine CurrentSince Oct 5, 2015 Accepting new patients

Locations

7640 Sylvania Ave
Ste K
Sylvania, OH 43560
Phone (419) 517-1001

2142 N Cove Blvd
Toledo, OH 43606
Phone (419) 291-1111

Organizations & group practices 1

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.

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": "1214438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1463529600000",
    "number": "1376705822",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7640 SYLVANIA AVE",
            "address_2": "STE K",
            "city": "SYLVANIA",
            "state": "OH",
            "postal_code": "435609263",
            "telephone_number": "419-824-1999",
            "fax_number": "419-882-7016"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5300 HARROUN RD",
            "address_2": "SUITE 170",
            "city": "SYLVANIA",
            "state": "OH",
            "postal_code": "435602182",
            "telephone_number": "419-824-1999",
            "fax_number": "419-882-7016"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATHUR",
        "first_name": "ARUN",
        "middle_name": "DEEPAK",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-06-26",
        "last_updated": "2016-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "35096157",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3154349",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sylvania, OH

Sources for this page

Verify at the official NPI Registry.