Individual provider Active NPI

Julie Mathew, PA-C

  • Physician Assistant
  • Stroudsburg, PA
National Provider Identifier
1609382571
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
MA058820 Issued in PA
Practice address
101 Pocono CMNS Ste 101
Stroudsburg, PA 18360-7599
Phone
(570) 872-9955
NPI assigned
Dec 14, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X MA058820 PA Primary

Addresses

Primary practice location

101 Pocono CMNS Ste 101
Stroudsburg, PA 18360-7599

Mailing address

115 Franklin Hill CT
East Stroudsburg, PA 18301-9233

Other practice location 1

4545 Milford Rd Ste 140
East Stroudsburg, PA 18302-9606
Phone (570) 872-9615

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20201116003132 TX Practitioner - Physician Assistant 7719246669 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Primary Health Physicians PLLCGroup PAC ID 7810237740, 240 clinicians

Practice addresses (Care Compare)

2221 Abrams Rd
Dallas, TX 75214-3620
Phone (972) 674-8510

2310 W University Dr
Suite 1500
Denton, TX 76201-1650
Phone (940) 220-5901

2404 McKinney Ave
Dallas, TX 75201-1936
Phone (214) 721-0630

3090 N Goliad St
Rockwall, TX 75087-7007
Phone (972) 722-0011

3591 McKinney St
Suite 400
Melissa, TX 75454-9504
Phone (972) 464-1611

377 W Campbell Rd
Suite 100
Richardson, TX 75080-3695
Phone (469) 232-2945

3821 W Spring Creek Pkwy
Plano, TX 75023-3808
Phone (972) 599-0077

4501 Lemmon Ave
Dallas, TX 75219-2145
Phone (469) 672-4238

4530 W University Dr
Prosper, TX 75078-9090
Phone (469) 607-7504

4844 Greenville Ave
Dallas, TX 75206-4120
Phone (214) 295-9410

9540 Garland Rd
Dallas, TX 75218-5004
Phone (214) 321-0015

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MA058820PAMDPhysician Assistant

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.

NPI Registry JSON

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

{
    "created_epoch": "1513209600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1609382571",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 FRANKLIN HILL CT",
            "city": "EAST STROUDSBURG",
            "state": "PA",
            "postal_code": "183019233"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 POCONO CMNS STE 101",
            "city": "STROUDSBURG",
            "state": "PA",
            "postal_code": "183607599",
            "telephone_number": "570-872-9955"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4545 Milford Rd Ste 140",
            "address_purpose": "LOCATION",
            "city": "East Stroudsburg",
            "state": "PA",
            "postal_code": "183029606",
            "country_code": "US",
            "telephone_number": "570-872-9615",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MATHEW",
        "first_name": "JULIE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-12-14",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA058820",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stroudsburg, PA

Sources for this page

Verify at the official NPI Registry.