Individual provider Active NPI

Lisa K Mathew, M.D.

  • Gastroenterology Physician
  • Castle Rock, CO
National Provider Identifier
1639331200
Registry record updated Aug 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
DR.0054046 Issued in CO
Practice address
3911 Ambrosia St Ste 201
Castle Rock, CO 80109-3888
Phone
(303) 788-8888
Fax
(844) 347-5158
NPI assigned
Jun 25, 2008
Last updated
Aug 23, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 23, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X DR.0054046 CO Primary

Addresses

Primary practice location

3911 Ambrosia St Ste 201
Castle Rock, CO 80109-3888

Mailing address

3911 Ambrosia St Ste 201
Castle Rock, CO 80109-3888
Phone (303) 788-8888

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
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

Enrollment IDStateProvider typePAC IDDetails
I20141020000771 CO Practitioner - Gastroenterology 3173744034 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
Duke University School of Medicine, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

10103 Ridgegate Pkwy
Suite 312
Lone Tree, CO 80124-5525
Phone (303) 788-8888

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy63
Upper gastrointestinal (GI) endoscopy for acid reflux39

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
DR.0054046COMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
South Denver Gastroenterology, PC Gastroenterology CurrentSince Dec 10, 2021 Accepting new patients

Locations

10103 Ridgegate Pkwy
Ste 312
Lone Tree, CO 80124
Phone (303) 788-8888

Interoperability endpoints

  • Direct secure messaging: lisa.mathew.1@3461.direct.athenahealth.com

Organizations & group practices 2

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.

Hospital & facility affiliations 2

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": "1214352000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692748800000",
    "number": "1639331200",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3911 AMBROSIA ST STE 201",
            "city": "CASTLE ROCK",
            "state": "CO",
            "postal_code": "801093888",
            "telephone_number": "303-788-8888",
            "fax_number": "844-347-5158"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3911 AMBROSIA ST STE 201",
            "city": "CASTLE ROCK",
            "state": "CO",
            "postal_code": "801093888",
            "telephone_number": "303-788-8888",
            "fax_number": "844-347-5158"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATHEW",
        "first_name": "LISA",
        "middle_name": "K",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-25",
        "last_updated": "2023-08-23",
        "certification_date": "2023-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "CO",
            "license": "DR.0054046",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Castle Rock, CO

Sources for this page

Verify at the official NPI Registry.