Active NPI
Vidya Mathivanan, MD
- Internal Medicine Physician
- Sugar Land, TX
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- N 3875
- Practice address
- 16659 Southwest Fwy
Sugar Land, TX 77479-2375 - Phone
- (281) 812-7404
- NPI assigned
- Jun 7, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | N 3875 | TX | Primary |
Addresses
Primary practice location
16659 Southwest Fwy
Sugar Land, TX 77479-2375
Mailing address
2607 Gallion Dr
Sugar Land, TX 77479-1967
Phone (281) 812-7404
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20091023000320 | TX | Practitioner - Internal Medicine | 6507903598 | Reassigns benefits to 1 organization |
Care Compare profile
Medicare Care Compare- Specialty
- Internal Medicine
- Education
- Other, 1998
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
1550 1St Colony Blvd
Sugar Land, TX 77479-4000
Phone (281) 221-1010
Hospital & facility affiliations
- Memorial Hermann Hospital System
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| N 3875 | TX | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ella Hospitalist PA | Internal Medicine | Current | Accepting new patients |
Locations
7600 Beechnut St
Houston, TX 77074
Phone (713) 456-5000
17500 W Grand Pkwy S
Sugar Land, TX 77479
Phone (281) 725-5000
1550 First Colony Blvd
Sugar Land, TX 77479
Phone (281) 275-6000
Organizations & group practices 1
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 6
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": "1181174400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1423612800000",
"number": "1508069659",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2607 GALLION DR",
"city": "SUGAR LAND",
"state": "TX",
"postal_code": "774791967",
"telephone_number": "281-812-7404"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "16659 SOUTHWEST FWY",
"city": "SUGAR LAND",
"state": "TX",
"postal_code": "774792375",
"telephone_number": "281-812-7404"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MATHIVANAN",
"first_name": "VIDYA",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-06-07",
"last_updated": "2015-02-11",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "TX",
"license": "N 3875",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sugar Land, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2015; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.