NPIMap

Individual provider Active NPI

Mathew Oommen, MD

  • Urology Physician
  • Minot, ND
National Provider Identifier
1467406140
Registry record updated Sep 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
20273 Issued in ND
Practice address
2305 37TH Ave SW
Minot, ND 58701-7669
Phone
(701) 418-7200
Fax
(701) 418-7201
NPI assigned
May 19, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X 20273 ND Primary
Urology Physician 208800000X ME113973 FL
Urogynecology and Reconstructive Pelvic Surgery (Urology) Physician 2088F0040X ME113973 FL

Addresses

Primary practice location

2305 37TH Ave SW
Minot, ND 58701-7669

Mailing address

PO Box 5010
Minot, ND 58702-5010
Phone (701) 418-8000

Other practice location 1

1812 N Mills Ave
Orlando, FL 32803-1834
Phone (407) 897-3499

Other practice location 2

1600 Lakeland Hills Blvd
Lakeland, FL 33805-3019
Phone (863) 680-7000

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address moommen18465@direct.watsonclinicad.com Watson Clinic LLP
CONNECT URL https://cobiusconnect.cobius.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other Cobius Healthcare Solutions

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ND
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231106002298 ND Practitioner - Urology 5991760936 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Trinity HealthGroup PAC ID 7911816020, 292 clinicians

Practice addresses (Care Compare)

2305 37TH Ave SW
Minot, ND 58701-7669
Phone (701) 418-8000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
81.05 of 100Reported as group
Quality
60.57
Promoting interoperability
98
Improvement activities
40
Cost
77.93

Procedures performed for Medicare patients

ProcedureNumber of procedures
Prostate resection1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME113973FLMDFemale Pelvic Medicine and Reconstructive Surgery (Urology) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Trinity Health CurrentSince Oct 10, 2023 Accepting new patients
Trinity Health CurrentSince Oct 10, 2023 Accepting new patients
Trinity Health Current Accepting new patients
Monroe Hma Physician Management LLC Obstetrics & Gynecology PastSince Jan 13, 2014 Accepting new patients
Frances Mahon Deaconess Hospital Past Accepting new patients
Lafayette OB Hospitalists LLC Obstetrics & Gynecology Past Accepting new patients
Watson Clinic LLP Past Accepting new patients

Locations

2720 Dundee Rd
Northbrook, IL 60062
Phone (224) 226-5222

2305 37th Ave SW
Minot, ND 58701
Phone (701) 418-8550

101 3rd Ave SW
Minot, ND 58701
Phone (701) 857-5286

Organizations & group practices 7

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 10

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": "1147996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758672000000",
    "number": "1467406140",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5010",
            "city": "MINOT",
            "state": "ND",
            "postal_code": "587025010",
            "telephone_number": "701-418-8000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2305 37TH AVE SW",
            "city": "MINOT",
            "state": "ND",
            "postal_code": "587017669",
            "telephone_number": "701-418-7200",
            "fax_number": "701-418-7201"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1812 N Mills Ave",
            "address_purpose": "LOCATION",
            "city": "Orlando",
            "state": "FL",
            "postal_code": "328031834",
            "country_code": "US",
            "telephone_number": "407-897-3499",
            "fax_number": "407-956-3373",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1600 Lakeland Hills Blvd",
            "address_purpose": "LOCATION",
            "city": "Lakeland",
            "state": "FL",
            "postal_code": "338053019",
            "country_code": "US",
            "telephone_number": "863-680-7000",
            "fax_number": "866-264-8519",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OOMMEN",
        "first_name": "MATHEW",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-19",
        "last_updated": "2025-09-24",
        "certification_date": "2025-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "ND",
            "license": "20273",
            "primary": true
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "FL",
            "license": "ME113973",
            "primary": false
        },
        {
            "code": "2088F0040X",
            "taxonomy_group": "",
            "desc": "Urology, Urogynecology and Reconstructive Pelvic Surgery",
            "state": "FL",
            "license": "ME113973",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "moommen18465@direct.watsonclinicad.com",
            "affiliation": "Y",
            "endpointDescription": "Direct Messaging Address",
            "affiliationName": "Watson Clinic LLP",
            "address_1": "1430 Lakeland Hills Blvd",
            "city": "Lakeland",
            "state": "FL",
            "country_code": "US",
            "postal_code": "338053202",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://cobiusconnect.cobius.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.1068.1",
            "affiliationName": "Cobius Healthcare Solutions",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "2720 Dundee Rd # 302",
            "city": "Northbrook",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600622609",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Minot, ND

Sources for this page

Verify at the official NPI Registry.