NPIMap

Individual provider Active NPI

Della Mathew, MD

  • Internal Medicine Physician
  • Buffalo Grove, IL
National Provider Identifier
1629028428
Registry record updated Jan 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
036-109903 Issued in IL
Practice address
150 W Half Day Rd
Suite 103
Buffalo Grove, IL 60089-6591
Phone
(847) 955-1144
Fax
(847) 955-1166
NPI assigned
May 11, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 28, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 036-109903 IL Primary

Addresses

Primary practice location

150 W Half Day Rd
Suite 103
Buffalo Grove, IL 60089-6591

Mailing address

12200 Park Central Dr Ste 189
Dallas, TX 75251-2116
Phone (972) 239-5445

Other names 1

  • Della Thomas Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150522002015 TX Practitioner - Internal Medicine 7416914924 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Katikaneni S MD PAGroup PAC ID 5890120174, 2 clinicians
Shalini Katikaneni MD PAGroup PAC ID 3678617396, 5 clinicians

Practice addresses (Care Compare)

6190 LBJ Fwy
Suite 200
Dallas, TX 75240-6347
Phone (972) 239-5445

700 E Vista Ridge Mall Dr
Lewisville, TX 75067-8339
Phone (972) 906-9789

Hospital & facility affiliations

  • Accentcare Home Health of McKinney Home health agency, McKinney, TX, CCN 679236
  • Divinity Healthcare Hospice, Fort Worth, TX, CCN 971560
  • Medical City Dallas Hospital Hospital, Dallas, TX, CCN 450647
  • Traymore Nursing Center Nursing home, Dallas, TX, CCN 675754

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036-109903ILMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Katikaneni S MD PA Internal Medicine CurrentSince Sep 19, 2019 Accepting new patients
Shalini Katikaneni MD PA CurrentSince Sep 15, 2019 Accepting new patients
Lake Mi Mobile Doctors P.C. Past Accepting new patients
Alliance Medical Group,S.C Internal Medicine PastSince Jan 25, 2006 Accepting new patients
Nocona Hospital District Past Accepting new patients
Vpa PC Internal Medicine Past Accepting new patients

Locations

310 S Jupiter Rd
Allen, TX 75002
Phone (972) 437-0250

12200 Park Central Dr
Ste 189
Dallas, TX 75251
Phone (972) 503-5300

6190 Lyndon B Johnson Fwy
Ste 200
Dallas, TX 75240
Phone (817) 846-8502

700 E Vista Ridge Mall Dr
Lewisville, TX 75067
Phone (214) 315-6310

Interoperability endpoints

  • Direct secure messaging: della.mathew.p1@direct.lbucc.nextgenshare.com
  • Direct secure messaging: della.mathew@pima1.eclinicaldirectplus.com

Organizations & group practices 6

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.

Hospital & facility affiliations 5

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

NPI Registry JSON

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

{
    "created_epoch": "1147305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611792000000",
    "number": "1629028428",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12200 PARK CENTRAL DR STE 189",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752512116",
            "telephone_number": "972-239-5445",
            "fax_number": "469-729-6691"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 W HALF DAY RD",
            "address_2": "SUITE 103",
            "city": "BUFFALO GROVE",
            "state": "IL",
            "postal_code": "600896591",
            "telephone_number": "847-955-1144",
            "fax_number": "847-955-1166"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATHEW",
        "first_name": "DELLA",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-05-11",
        "last_updated": "2021-01-28",
        "certification_date": "2021-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036-109903",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DELLA",
            "last_name": "THOMAS",
            "credential": "MBBS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Buffalo Grove, IL

Sources for this page

Verify at the official NPI Registry.