Individual provider Active NPI

Neena T Mathew, ARNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Kissimmee, FL
National Provider Identifier
1487036539
Registry record updated Jul 12, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
ARNP9401350 Issued in FL
Practice address
206 Park Place Blvd
Kissimmee, FL 34741-2344
Phone
(407) 846-0023
Fax
(407) 933-7890
NPI assigned
Jun 25, 2015
Last updated
Jul 12, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 12, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X ARNP9401350 FL
Psychiatric/Mental Health Nurse Practitioner 363LP0808X ARNP9401350 FL Primary

Addresses

Primary practice location

206 Park Place Blvd
Kissimmee, FL 34741-2344

Mailing address

206 Park Place Blvd
Kissimmee, FL 34741-2344
Phone (407) 846-0023

Other identifiers 1

IdentifierTypeStateIssuer
ARNP9401350OtherFLLIC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160602002585 FL Practitioner - Nurse Practitioner 3870883853 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
MCCD FL Psychiatry Services PAGroup PAC ID 4880064070, 751 clinicians

Practice addresses (Care Compare)

101 N Monroe St
Suite 800 Private Office 860
Tallahassee, FL 32301-1570
Phone (833) 351-8255

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
MCCD FL Psychiatry Services PA CurrentSince Mar 24, 2025 Accepting new patients
Osceola Mental Health Inc CurrentSince Aug 1, 2016 Accepting new patients
Mindful Integrated Medicine LLC PastSince Feb 22, 2016 Accepting new patients

Locations

1301 Riverplace Blvd
Jacksonville, FL 32207

1507 Bill Beck Blvd
Kissimmee, FL 34744
Phone (407) 943-8618

200 Park Place Blvd
Kissimmee, FL 34741
Phone (407) 846-0023

206 Park Place Blvd
Kissimmee, FL 34741
Phone (407) 846-0023

2940 Pleasant Hill Rd
Kissimmee, FL 34746
Phone 4078460023 ext. 5107

208 Park Place Blvd
Kissimmee, FL 34741
Phone (321) 900-3074

101 N Monroe St
Ste 800
Tallahassee, FL 32301
Phone (321) 300-2108

109 W 27th St
Rm 5S
New York, NY 10001
Phone (332) 230-4572

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1435190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1562889600000",
    "number": "1487036539",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "206 PARK PLACE BLVD",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347412344",
            "telephone_number": "407-846-0023",
            "fax_number": "407-933-7890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "206 PARK PLACE BLVD",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347412344",
            "telephone_number": "407-846-0023",
            "fax_number": "407-933-7890"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATHEW",
        "first_name": "NEENA",
        "middle_name": "T",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-25",
        "last_updated": "2019-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "ARNP9401350",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "FL",
            "license": "ARNP9401350",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LIC",
            "identifier": "ARNP9401350",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kissimmee, FL

Sources for this page

Verify at the official NPI Registry.