Individual provider Active NPI

Cory Michael Mathias, DO

  • Family Medicine Physician
  • Smethport, PA
National Provider Identifier
1467897215
Registry record updated Mar 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
1288 Issued in NE
Practice address
406 Franklin St
Smethport, PA 16749-1277
Phone
(814) 887-5655
Fax
(814) 887-1911
NPI assigned
May 7, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 30, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 1288 NE Primary

Addresses

Primary practice location

406 Franklin St
Smethport, PA 16749-1277

Mailing address

908 Niagara Falls Blvd Ste 208
North Tonawanda, NY 14120-2019
Phone (716) 692-3302

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20200916001759 PA Practitioner - Family Practice 6800108341 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
West Virginia School of Osteopathic Medicine, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bradford Regional Medical CenterGroup PAC ID 4789592775, 5 clinicians
Olean General HospitalGroup PAC ID 9133111784, 78 clinicians

Practice addresses (Care Compare)

116 Interstate Pkwy
Bradford, PA 16701-1036

406 Franklin St
Smethport, PA 16749-1277
Phone (814) 887-5655

Hospital & facility affiliations

  • Vna of Northwest PA, LLC Home health agency, Bradford, PA, CCN 397130
  • Family Hospice Hospice, Williamsport, PA, CCN 391513
  • Olean General Hospital Hospital, Olean, NY, CCN 330103
  • Upmc Cole Hospital, Coudersport, PA, CCN 391313
  • Upmc Kane Hospital, Kane, PA, CCN 391318

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1288NEMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Olean General Hospital Current Accepting new patients
Olean General Hospital Family Medicine CurrentSince Oct 15, 2020 Accepting new patients
Olean General Hospital Family Medicine CurrentSince Oct 15, 2020 Accepting new patients

Locations

908 Niagara Falls Blvd
Ste 208
North Tonawanda, NY 14120
Phone (716) 649-1613

116 Interstate Pkwy
Bradford, PA 16701
Phone (814) 362-8674

200 Pleasant St
Bradford, PA 16701
Phone (814) 362-8293

406 Franklin St
Smethport, PA 16749
Phone (814) 887-5655

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.

Hospital & facility affiliations 8

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": "1367884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1585526400000",
    "number": "1467897215",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "908 NIAGARA FALLS BLVD STE 208",
            "city": "NORTH TONAWANDA",
            "state": "NY",
            "postal_code": "141202019",
            "telephone_number": "716-692-3302",
            "fax_number": "933-953-2016"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "406 FRANKLIN ST",
            "city": "SMETHPORT",
            "state": "PA",
            "postal_code": "167491277",
            "telephone_number": "814-887-5655",
            "fax_number": "814-887-1911"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATHIAS",
        "first_name": "CORY",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-05-07",
        "last_updated": "2020-03-30",
        "certification_date": "2020-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NE",
            "license": "1288",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Smethport, PA

Sources for this page

Verify at the official NPI Registry.