Individual provider Active NPI

Matthew Mindlin, PA-C, MHS

  • Medical Physician Assistant
  • Pennington, NJ
National Provider Identifier
1629460407
Registry record updated Mar 3, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
25MP00361600 Issued in NJ
Practice address
1 Capital Way
Pennington, NJ 08534-2520
Phone
(609) 303-4000
NPI assigned
Mar 3, 2015
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 3, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 25MP00361600 NJ Primary

Addresses

Primary practice location

1 Capital Way
Pennington, NJ 08534-2520

Mailing address

1 Capital Way
Pennington, NJ 08534-2520

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20170515000721 PA Practitioner - Physician Assistant 3375860380 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MP00361600NJMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Care Services of Pennsylvania, P.C. CurrentSince May 1, 2017 Accepting new patients
Doylestown Emergency Associates PC Past Accepting new patients

Locations

1201 Langhorne Newtown Rd
Penndel, PA 19047
Phone (215) 710-2100

Organizations & group practices 4

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": "1425340800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1425340800000",
    "number": "1629460407",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 CAPITAL WAY",
            "city": "PENNINGTON",
            "state": "NJ",
            "postal_code": "085342520"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 CAPITAL WAY",
            "city": "PENNINGTON",
            "state": "NJ",
            "postal_code": "085342520",
            "telephone_number": "609-303-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MINDLIN",
        "first_name": "MATTHEW",
        "name_prefix": "Mr.",
        "credential": "PA-C, MHS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-03-03",
        "last_updated": "2015-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NJ",
            "license": "25MP00361600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pennington, NJ

Sources for this page

Verify at the official NPI Registry.