Manoj Mathew, M.D.

Primary specialty

Pulmonary Disease PhysicianTaxonomy code 207RP1001X

License

33087 Issued in AZ

Practice address

3811 E Bell Rd Ste 107
Phoenix, AZ 85032-2158

Phone

(602) 340-1689

Fax

(602) 340-1853

NPI assigned

Mar 29, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in AZ

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Arizona Acute Medical Services 1 PC

  • Hospitalist Physician
  • Phoenix, AZ
  • NPI 1154860674
  Medicare reassignment NPD
• Arizona Post-Acute Medical Services 1 PC

  • Hospitalist Physician
  • Phoenix, AZ
  • NPI 1093254419
  NPD (past)
• City of Hope Medical Group of Arizona LLC

  • Medical Oncology Physician
  • Goodyear, AZ
  • NPI 1609026806

  Internal Medicine

  NPD (past)

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

{
    "created_epoch": "1175126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607644800000",
    "number": "1467572107",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5151 E BROADWAY RD STE 107",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852061346",
            "telephone_number": "480-290-7000",
            "fax_number": "602-254-6840"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3811 E BELL RD STE 107",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850322158",
            "telephone_number": "602-340-1689",
            "fax_number": "602-340-1853"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "19841 N 27th Ave Ste 102",
            "address_purpose": "LOCATION",
            "city": "Phoenix",
            "state": "AZ",
            "postal_code": "850274004",
            "country_code": "US",
            "telephone_number": "602-258-4951",
            "fax_number": "623-434-8310",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MATHEW",
        "first_name": "MANOJ",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-29",
        "last_updated": "2020-12-11",
        "certification_date": "2020-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "AZ",
            "license": "33087",
            "primary": true
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "AZ",
            "license": "33087",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AZ MD LIC",
            "identifier": "33087",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UPIN",
            "identifier": "874554",
            "state": "AZ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "874554",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jacob Matheus Horn
• Mathew LLC
• Dillon Mathew-Gilmore
• Anna Rekha Mathew
• Beena Mathew, NP
• Paige Mathew, PHARMD
• Subin John Mathew
• Mya L Mathews-Frazer, RBT
• Heather Renee Mathews-King, RD
• Jean E Mathews, RCP

• Pulmonary Disease Physician in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Pulmonary Disease Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.