Siju Mathew, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

26NJ00554700 Issued in NJ

Practice address

1 Bay Ave
Anesthesia Office
Montclair, NJ 07042-4837

Phone

(973) 429-6219

Fax

(845) 547-0740

NPI assigned

Jan 6, 2015

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

New Jersey Healthcare Specialists PCGroup PAC ID 2668385253, 570 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Hackensack Meridian Health Pascack Valley Medical Hospital, Westwood, NJ, CCN 310130

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

State licenses

Practice roles

Locations

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.

• New Jersey Healthcare Specialists PC

  • Anesthesiology Physician
  • Hackensack, NJ
  • NPI 1174585780
  Medicare reassignment Care Compare group NPD
• North American Partners in Anesthesia of New Jersey LLC

  • Anesthesiology Physician
  • Brick, NJ
  • NPI 1548433048
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Pascack Valley Hospital LLC

  dba HackensackUMC at Pascack Valley

  • General Acute Care Hospital
  • Westwood, NJ
  • NPI 1205176062
  Care Compare affiliation

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

{
    "created_epoch": "1420502400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1432598400000",
    "number": "1558759191",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 ROUTE 59",
            "address_2": "SUITE 105",
            "city": "SUFFERN",
            "state": "NY",
            "postal_code": "109014927",
            "telephone_number": "845-357-5775",
            "fax_number": "845-357-5777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 BAY AVE",
            "address_2": "ANESTHESIA OFFICE",
            "city": "MONTCLAIR",
            "state": "NJ",
            "postal_code": "070424837",
            "telephone_number": "973-429-6219",
            "fax_number": "845-547-0740"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATHEW",
        "first_name": "SIJU",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-01-06",
        "last_updated": "2015-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NJ",
            "license": "26NR15938100",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NJ",
            "license": "26NJ00554700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mary Cullen-Drill Apn LLC
• Marykate Horrigan, LLC
• Rachel Francine Maslow, DPM
• Sharon E Mason-Bell, M.D.
• Mary Massaro, MS, NCPSYA
• Natasha M Mathias, DMD
• Emily Demuro Matlosz, IBCLC
• Rosaria Matos, LCSW
• Joyce L Mauer, MSW, LCSW
• Lauren Maynard

• Certified Registered Nurse Anesthetist in Montclair, NJ
• Providers in Montclair, NJ by specialty
• Certified Registered Nurse Anesthetist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.

Verify at the official NPI Registry.