Individual provider Active NPI

Ranjit Cherian Mathew, M.D. PH.D

  • Gastroenterology Physician
  • Athens, GA
National Provider Identifier
1437150463
Registry record updated Aug 20, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
037286 Issued in GA
Practice address
170 Hawthorne Park
Athens, GA 30606-2147
Phone
(706) 549-1222
Fax
(706) 549-9975
NPI assigned
Aug 1, 2005
Reactivated
Mar 28, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X 037286 GA Primary

Addresses

Primary practice location

170 Hawthorne Park
Athens, GA 30606-2147

Mailing address

1500 Oglethorpe Avenue
Suite 600F
Athens, GA 30606
Phone (706) 549-1222

Other identifiers 1

IdentifierTypeStateIssuer
000576837AMedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20080527000428 GA Practitioner - Gastroenterology 2769551118

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
037286GAMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mohammed Obeidin, MD. Past Accepting new patients
Kimberly Walpert, M.D., LLC Past Accepting new patients
Gregory a. Delaurier, M.D., Colorectal and General Surgery, P.C. Past Accepting new patients

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1122854400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1408492800000",
    "number": "1437150463",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 OGLETHORPE AVENUE",
            "address_2": "SUITE 600F",
            "city": "ATHENS",
            "state": "GA",
            "postal_code": "30606",
            "telephone_number": "706-549-1222",
            "fax_number": "706-549-9975"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "170 HAWTHORNE PARK",
            "city": "ATHENS",
            "state": "GA",
            "postal_code": "306062147",
            "telephone_number": "706-549-1222",
            "fax_number": "706-549-9975"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATHEW",
        "first_name": "RANJIT",
        "middle_name": "CHERIAN",
        "name_prefix": "Dr.",
        "credential": "M.D. PH.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-01",
        "last_updated": "2014-08-20",
        "deactivation_date": "2006-03-21",
        "reactivation_date": "2006-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "GA",
            "license": "037286",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000576837A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Athens, GA

Sources for this page

Verify at the official NPI Registry.