Judith Del Carmen Mathura, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

ME115042 Issued in FL

Practice address

110 Pond CT Ste 203
Debary, FL 32713-2717

Phone

(386) 259-4106

Fax

(866) 554-1654

NPI assigned

Apr 30, 2013

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Dr. Judith Del Carmen Gutierrez Former name

Electronic endpoints 1

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Mathura Medical Group Inc

  • Family Medicine Physician
  • Debary, FL
  • NPI 1871160960
  Medicare reassignment NPD
• Deland Family Medicine PA

  • Family Medicine Physician
  • Deland, FL
  • NPI 1700997871
  NPD (past)

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

{
    "created_epoch": "1367280000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687910400000",
    "number": "1609211069",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 POND CT STE 203",
            "city": "DEBARY",
            "state": "FL",
            "postal_code": "327132717",
            "telephone_number": "386-259-4106",
            "fax_number": "866-554-1654"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 POND CT STE 203",
            "city": "DEBARY",
            "state": "FL",
            "postal_code": "327132717",
            "telephone_number": "386-259-4106",
            "fax_number": "866-554-1654"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATHURA",
        "first_name": "JUDITH",
        "middle_name": "DEL CARMEN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-04-30",
        "last_updated": "2023-06-28",
        "certification_date": "2023-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME115042",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "eClinicalworks",
            "affiliation": "N",
            "address_1": "110 Pond Ct Ste 203",
            "city": "Debary",
            "state": "FL",
            "country_code": "US",
            "postal_code": "327132717",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "JUDITH",
            "last_name": "GUTIERREZ",
            "middle_name": "DEL CARMEN",
            "prefix": "DR.",
            "credential": "M.D",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Sage Mikayla Maiolo, DC
• Frank Mari, MD
• Manuela C Marin, LMHC
• Michelle Marpole
• Mathura Medical Group Inc
• Shiva A Mathura, MD
• Vincent T Mattiello, DC
• Emily Maza
• Ryan Patrick McNeel, DC
• Medical Home Alliance LLC

• Family Medicine Physician in Debary, FL
• Providers in Debary, FL by specialty
• Family Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2023; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.