Individual provider Active NPI

Sherly Mathew, M.D.

  • Internal Medicine Physician
  • Hyde Park, NY
National Provider Identifier
1386064954
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
290594 Issued in NY
Practice address
4068 Albany Post Rd
Hyde Park, NY 12538-3900
Phone
(845) 229-2123
Fax
(845) 229-6313
NPI assigned
Apr 22, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 290594 NY Primary

Addresses

Primary practice location

4068 Albany Post Rd
Hyde Park, NY 12538-3900

Mailing address

1351 Route 55 Ste 200
Lagrangeville, NY 12540-5128
Phone (845) 475-9660

Other practice location 1

2250 Fuller Wiser Rd Apt 8102
Euless, TX 76039-4289
Phone (845) 729-9334

Other identifiers 1

IdentifierTypeStateIssuer
04863310MedicaidNY

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
I20200214001999 TX Practitioner - Internal Medicine 2769756246 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Healthtexas Provider NetworkGroup PAC ID 1355254210, 2,535 clinicians

Practice addresses (Care Compare)

1400 8TH Ave
Fort Worth, TX 76104-4110

4001 Worth St
Dallas, TX 75246-1608

5408 Colleyville Blvd
Colleyville, TX 76034-5833
Phone (817) 498-9920

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
290594NYMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Healthtexas Provider Network CurrentSince Feb 17, 2020 Accepting new patients
Healthtexas Provider Network Internal Medicine Current Accepting new patients
Healthtexas Provider Network Internal Medicine CurrentSince Feb 17, 2020 Accepting new patients
Healthtexas Provider Network Past Accepting new patients
Baylor All Saints Medical Center Past Accepting new patients

Locations

5408 Colleyville Blvd
Colleyville, TX 76034
Phone (817) 498-9920

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

8080 N Central Expy
Ste 600
Dallas, TX 75206
Phone (972) 860-8648

1400 8th Ave
#C770
Fort Worth, TX 76104
Phone (817) 922-1770

1400 8th Ave
Ft Worth, TX 76104
Phone (817) 922-1559

Interoperability endpoints

  • Direct secure messaging: smathew568642@direct.sw.org

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 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": "1398124800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1386064954",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1351 ROUTE 55 STE 200",
            "city": "LAGRANGEVILLE",
            "state": "NY",
            "postal_code": "125405128",
            "telephone_number": "845-475-9660",
            "fax_number": "845-475-9938"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4068 ALBANY POST RD",
            "city": "HYDE PARK",
            "state": "NY",
            "postal_code": "125383900",
            "telephone_number": "845-229-2123",
            "fax_number": "845-229-6313"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2250 Fuller Wiser Rd Apt 8102",
            "address_purpose": "LOCATION",
            "city": "Euless",
            "state": "TX",
            "postal_code": "760394289",
            "country_code": "US",
            "telephone_number": "845-729-9334",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MATHEW",
        "first_name": "SHERLY",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-04-22",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "290594",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "04863310",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hyde Park, NY

Sources for this page

Verify at the official NPI Registry.