Individual provider Active NPI

Rinu Mathew, PA-C

  • Medical Physician Assistant
  • Oklahoma City, OK
National Provider Identifier
1649785049
Registry record updated Apr 15, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
2999 Issued in OK
Practice address
4913 W Reno Ave
Oklahoma City, OK 73127-6339
Phone
(405) 948-4900
NPI assigned
Dec 6, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 15, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 25MP00456900 NJ
Medical Physician Assistant 363AM0700X 2999 OK Primary

Addresses

Primary practice location

4913 W Reno Ave
Oklahoma City, OK 73127-6339

Mailing address

4913 W Reno Ave
Oklahoma City, OK 73127-6339
Phone (405) 948-4900

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
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
I20200108001657 OK Practitioner - Physician Assistant 8022379171 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy Hospital Logan County, IncGroup PAC ID 4587836200, 25 clinicians

Practice addresses (Care Compare)

200 S Academy Rd
Guthrie, OK 73044-1017
Phone (405) 282-6700

200 S Academy Rd
Guthrie, OK 73044-8727
Phone (405) 282-6700

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2999OKMDMental Health Counselor
25MP00456900NJMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Hospital Logan County, Inc CurrentSince Aug 14, 2023 Accepting new patients

Locations

200 S Academy Rd
Guthrie, OK 73044
Phone (405) 260-4165

Interoperability endpoints

  • Direct secure messaging: rmathew1044746@directc.mercy.net

Organizations & group practices 3

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 3

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": "1512518400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1555286400000",
    "number": "1649785049",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4913 W RENO AVE",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731276339",
            "telephone_number": "405-948-4900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4913 W RENO AVE",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731276339",
            "telephone_number": "405-948-4900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATHEW",
        "first_name": "RINU",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-12-06",
        "last_updated": "2019-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NJ",
            "license": "25MP00456900",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "OK",
            "license": "2999",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

Verify at the official NPI Registry.