Individual provider Active NPI

Naomi Elizabeth Mathew, M.D.

  • Pulmonary Disease Physician
  • Harker Heights, TX
National Provider Identifier
1376857292
Registry record updated Dec 9, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
Q9435 Issued in TX
Practice address
850 W Central Texas Expy
Harker Heights, TX 76548-1890
Phone
(254) 618-1090
NPI assigned
Aug 3, 2010
Last updated
Dec 9, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 9, 2019

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 4301097145 MI
Critical Care Medicine (Internal Medicine) Physician 207RC0200X Q9435 TX
Pulmonary Disease Physician 207RP1001X Q9435 TX Primary

Addresses

Primary practice location

850 W Central Texas Expy
Harker Heights, TX 76548-1890

Mailing address

804 Copper Ridge Loop
Temple, TX 76502-5099

Other practice location 1

138 Service Rd
A225 Clinical Center
East Lansing, MI 48824-1376
Phone (517) 353-4941

Other identifiers 3

IdentifierTypeStateIssuer
372079909MedicaidTX
8LQ106OtherTXBCBS
861926OtherTXMEDICARE

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170428001204 TX Practitioner - Critical Care (Intensivists)Practitioner - Internal MedicinePractitioner - Pulmonary Disease 4486931466 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301097145MIMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Christus Trinity Clinic Texas Internal Medicine CurrentSince Nov 4, 2019 Accepting new patients
Austin Critical Care Specialists PA Critical Care Medicine CurrentSince Apr 8, 2017 Accepting new patients
Austin Critical Care Specialists PA Critical Care Medicine CurrentSince Apr 8, 2017 Accepting new patients
Christus Trinity Clinic Texas CurrentSince Nov 4, 2019 Accepting new patients

Locations

11113 Research Blvd
Austin, TX 78759
Phone (512) 324-1125

850 W Central Texas Expy
Killeen, TX 76548
Phone (254) 690-0900

6001 Kyle Pkwy
Kyle, TX 78640
Phone (512) 504-5000

630 S Fleishel Ave
Tyler, TX 75701
Phone (903) 510-8888

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1280793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1575849600000",
    "number": "1376857292",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "804 COPPER RIDGE LOOP",
            "city": "TEMPLE",
            "state": "TX",
            "postal_code": "765025099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "850 W CENTRAL TEXAS EXPY",
            "city": "HARKER HEIGHTS",
            "state": "TX",
            "postal_code": "765481890",
            "telephone_number": "254-618-1090"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "138 Service Rd",
            "address_2": "A225 Clinical Center",
            "address_purpose": "LOCATION",
            "city": "East Lansing",
            "state": "MI",
            "postal_code": "488241376",
            "country_code": "US",
            "telephone_number": "517-353-4941",
            "fax_number": "517-432-3145",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MATHEW",
        "first_name": "NAOMI",
        "middle_name": "ELIZABETH",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-08-03",
        "last_updated": "2019-12-09",
        "certification_date": "2019-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301097145",
            "primary": false
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "TX",
            "license": "Q9435",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "TX",
            "license": "Q9435",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "372079909",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "8LQ106",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "861926",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Harker Heights, TX

Sources for this page

Verify at the official NPI Registry.