NPIMap

Individual provider Active NPI

Lijo Parackel Mathai, PA-C

  • Physician Assistant
  • Bronx, NY
National Provider Identifier
1477921195
Registry record updated Sep 11, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
4422 3Rd Ave
Bronx, NY 10457-2545
Phone
(516) 849-4772
NPI assigned
Sep 11, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

4422 3Rd Ave
Bronx, NY 10457-2545

Mailing address

8142 263Rd St
Floral Park, NY 11004-1519
Phone (516) 849-4772

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20160913000778 NY Practitioner - Physician Assistant 0547556805 Reassigns benefits to 7 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Mercy College, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Midtown New York Doctors Urgent Care PLLCGroup PAC ID 4981851037, 7 clinicians

Practice addresses (Care Compare)

205 Lexington Ave
Suite 215
New York, NY 10016-6022
Phone (212) 684-4700

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Throgs Neck Urgent Medical Care PLLC Current Accepting new patients
North Shore - Lij Medical PC CurrentSince Jun 30, 2019 Accepting new patients
Hicksville Family Medical Care, PLLC Past Accepting new patients
Eastside Physicians of Nyc, PLLC PastSince Aug 12, 2022 Accepting new patients

Locations

484 Temple Hill Rd
Ste 103
New Windsor, NY 12553

300 Community Dr
Plandome, NY 11030

Interoperability endpoints

  • Direct secure messaging: lijomathai@nslijmedgr.allscriptsdirect.net

Organizations & group practices 11

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": "1441929600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1441929600000",
    "number": "1477921195",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8142 263RD ST",
            "city": "FLORAL PARK",
            "state": "NY",
            "postal_code": "110041519",
            "telephone_number": "516-849-4772"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4422 3RD AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104572545",
            "telephone_number": "516-849-4772"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATHAI",
        "first_name": "LIJO",
        "middle_name": "PARACKEL",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-09-11",
        "last_updated": "2015-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.