Jean-Wilner Mathieu, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

ME 0042195 Issued in FL

Practice address

1234 NE 4TH Ave
Suite a
Fort Lauderdale, FL 33304-1925

Phone

(954) 779-1667

Fax

(954) 760-7253

NPI assigned

Oct 11, 2005

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 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.

• Manor Plaza Pediatric & General Medicine Inc.

  • Pediatrics Physician
  • Fort Lauderdale, FL
  • NPI 1558657130
  NPD

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

{
    "created_epoch": "1128988800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1297641600000",
    "number": "1629066980",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1234 NE 4TH AVE",
            "address_2": "SUITE A",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333041925",
            "telephone_number": "954-779-1667",
            "fax_number": "954-760-7253"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1234 NE 4TH AVE",
            "address_2": "SUITE A",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333041925",
            "telephone_number": "954-779-1667",
            "fax_number": "954-760-7253"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATHIEU",
        "first_name": "JEAN-WILNER",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-10-11",
        "last_updated": "2011-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "ME 0042195",
            "primary": true
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "FL",
            "license": "ME 0042195",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "062870100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Charlie Mata, CRNA
• Fernando V. Mata, M.D.
• Joselyn M Mateo, MD
• Rejoy Mathai, APRN
• Smitha Mathew, PHARMD
• Phyllis Rena Mathis
• Matias Nemetz Matias, DO
• Alexandra Matos
• Michel Matouk, M.D.,DDS
• Peter V. Matrale, D.C.

• Pediatrics Physician in Fort Lauderdale, FL
• Providers in Fort Lauderdale, FL by specialty
• Pediatrics Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2011; 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.