Individual provider Active NPI

Albert Mathieu, PA

  • Physician Assistant
  • Phoenix, AZ
National Provider Identifier
1538819818
Registry record updated Feb 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
9696 Issued in AZ
Practice address
521 W Thomas Rd FL 2
Phoenix, AZ 85013-4241
Phone
(602) 254-0390
Fax
(480) 591-8950
NPI assigned
Mar 28, 2022
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 27, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 1237 PR
Physician Assistant 363A00000X TPPA338 FL
Physician Assistant 363A00000X 9696 AZ Primary

Addresses

Primary practice location

521 W Thomas Rd FL 2
Phoenix, AZ 85013-4241

Mailing address

222 E Jefferson St Apt 813
Phoenix, AZ 85004-0408
Phone (786) 403-3125

Medicare participation

Medicare enrollment files
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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240828003194 AZ Practitioner - Physician Assistant 2961849468 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
9696AZMDPharmacist
TPPA338FLMDPhysician Assistant
1237PRMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Serenity Mind Care Clinic PLLC CurrentSince Mar 11, 2025 Accepting new patients
First Response Solutions LLC PastSince Oct 15, 2023 Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1648425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740614400000",
    "number": "1538819818",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "222 E JEFFERSON ST APT 813",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850040408",
            "telephone_number": "786-403-3125",
            "fax_number": "480-591-8950"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "521 W THOMAS RD FL 2",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850134241",
            "telephone_number": "602-254-0390",
            "fax_number": "480-591-8950"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATHIEU",
        "first_name": "ALBERT",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-03-28",
        "last_updated": "2025-02-27",
        "certification_date": "2025-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PR",
            "license": "1237",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "TPPA338",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "9696",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.