Mathew M. Jose, M.D., Inc

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

35072597J Issued in OH

Legal business name

MATHEW M. JOSE, M.D., INC

Practice address

1015 S Blackhoof St
Wapakoneta, OH 45895-2209

Phone

(419) 738-3317

Fax

(419) 738-5952

NPI assigned

Sep 5, 2006

Last updated

Apr 4, 2011By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Mathew M Jose, M.D.NPI 1467429977

Title

Owner

Phone

(419) 738-3317

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in OH

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Mathew M Jose, MD

  • Family Medicine Physician
  • Wapakoneta, OH
  • NPI 1467429977
  Medicare reassignment Authorized official
• Cindy A Parziale, CNP

  • Family Nurse Practitioner
  • Sidney, OH
  • NPI 1356438899
  NPD (past)
• Joelyn M Etgen, NP-C

  • Family Nurse Practitioner
  • Fort Wayne, IN
  • NPI 1467722249
  NPD (past)

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

{
    "created_epoch": "1157414400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1301875200000",
    "number": "1447352786",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 39",
            "city": "WAPAKONETA",
            "state": "OH",
            "postal_code": "458950039",
            "telephone_number": "419-738-3317",
            "fax_number": "419-738-5952"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1015 S BLACKHOOF ST",
            "city": "WAPAKONETA",
            "state": "OH",
            "postal_code": "458952209",
            "telephone_number": "419-738-3317",
            "fax_number": "419-738-5952"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MATHEW M. JOSE, M.D., INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-05",
        "last_updated": "2011-04-04",
        "status": "A",
        "authorized_official_last_name": "JOSE",
        "authorized_official_first_name": "MATHEW",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "419-738-3317",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "35072597J",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE GROUP PTAN",
            "identifier": "DN5206",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2834893",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ashley N Lykins, MSW, LSW
• Majestic Care of Wapakoneta LLC
• Daniel G Makuh, DDS
• Kristiina Mangen, RN
• Kaitlin A Martin, CNP
• Clint Mathewson
• Christopher W Mavis
• Jaidyn Marie Mavis, INDEPENDENT PROVIDER
• Tiffanie Marie Mavis
• Weston Mavis

• Family Medicine Physician in Wapakoneta, OH
• Providers in Wapakoneta, OH by specialty
• Family Medicine Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.

Verify at the official NPI Registry.