Individual provider Active NPI

Glory Mathew, FNP

  • Family Nurse Practitioner
  • Yonkers, NY
National Provider Identifier
1609927995
Registry record updated Dec 28, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
33-334698 Issued in NY
Practice address
1010 N Broadway
Yonkers, NY 10701-1330
Phone
(914) 968-3535
Fax
(914) 968-3566
NPI assigned
Jan 15, 2007
Last updated
Dec 28, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 28, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 33-334698 NY Primary

Addresses

Primary practice location

1010 N Broadway
Yonkers, NY 10701-1330

Mailing address

1010 N Broadway
Yonkers, NY 10701-1330
Phone (914) 968-3535

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20060221000102 NY Practitioner - Nurse Practitioner 0143235606 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
SJR Medical, PCGroup PAC ID 5991608440, 43 clinicians

Practice addresses (Care Compare)

128 Ashford Ave
Dobbs Ferry, NY 10522-1924
Phone (914) 693-6500

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
33-334698NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mount Sinai School of Medicine of New York University CurrentSince Dec 5, 2016 Accepting new patients
Mount Sinai School of Medicine of New York University CurrentSince Dec 5, 2016 Accepting new patients
SJR Medical, PC Family CurrentSince Jul 21, 2025 Accepting new patients
Pak Podiatry Past Accepting new patients
Plaza East Internal Medicine PC Past Accepting new patients

Locations

128 Ashford Ave
Dobbs Ferry, NY 10522
Phone (914) 245-8936

128 Ashford Ave
Fl 2
Dobbs Ferry, NY 10522
Phone (914) 693-6500

1010 N Broadway
Yonkers, NY 10701
Phone (914) 968-3535

1088 N Broadway
Yonkers, NY 10701
Phone (914) 964-4965

120 Odell Ave
Yonkers, NY 10701
Phone (718) 863-5511

750 Kimball Ave
Yonkers, NY 10704
Phone (914) 237-6480

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359

Interoperability endpoints

  • Direct secure messaging: gmathew@stjohnsmedicalpc.directmedgenehr.com

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1168819200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1482883200000",
    "number": "1609927995",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1010 N BROADWAY",
            "city": "YONKERS",
            "state": "NY",
            "postal_code": "107011330",
            "telephone_number": "914-968-3535",
            "fax_number": "914-968-3566"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1010 N BROADWAY",
            "city": "YONKERS",
            "state": "NY",
            "postal_code": "107011330",
            "telephone_number": "914-968-3535",
            "fax_number": "914-968-3566"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATHEW",
        "first_name": "GLORY",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-15",
        "last_updated": "2016-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "33-334698",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Yonkers, NY

Sources for this page

Verify at the official NPI Registry.