Jaiba Paul Mathew, AGACNP-BC

Primary specialty

Acute Care Nurse PractitionerTaxonomy code 363LA2100X

License

RN207189 Issued in GA

Practice address

980 Johnson Fy Rd NE
Atlanta, GA 30342-1626

Phone

(404) 252-0256

Fax

(404) 252-0256

NPI assigned

Jul 8, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

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

Specialty

Nurse Practitioner

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

The Southeast Permanente Medical GroupGroup PAC ID 6204829013, 823 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Saint Joseph'S Hospital of Atlanta, Inc Hospital, Atlanta, GA, CCN 110082

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.441.396886

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.

• The Southeast Permanente Medical Group

  • Internal Medicine Physician
  • Atlanta, GA
  • NPI 1245266956
  Medicare reassignment Care Compare group NPD
• North Atlanta Kidney Specialists

  • Nephrology Physician
  • Atlanta, GA
  • NPI 1598872434
  Medicare reassignment NPD

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

• Saint Josephs Hospital of Atlanta Inc

  • General Acute Care Hospital
  • Atlanta, GA
  • NPI 1679664395
  Care Compare affiliation

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

{
    "created_epoch": "1594166400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594166400000",
    "number": "1669090460",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "840 STREAMVIEW WAY",
            "city": "ALPHARETTA",
            "state": "GA",
            "postal_code": "300045954",
            "telephone_number": "832-692-8396"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "980 JOHNSON FY RD NE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303421626",
            "telephone_number": "404-252-0256",
            "fax_number": "404-252-0256"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5665 Peachtree Dunwoody",
            "address_purpose": "LOCATION",
            "city": "Atlanta",
            "state": "GA",
            "postal_code": "303421764",
            "country_code": "US",
            "telephone_number": "678-843-7001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MATHEW",
        "first_name": "JAIBA",
        "middle_name": "PAUL",
        "credential": "AGACNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-07-08",
        "last_updated": "2020-07-08",
        "certification_date": "2020-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "GA",
            "license": "RN207189",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "GA",
            "license": "RN207189",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rachel Mather, MD
• Michael Jonathan Mathers, M.D.
• Carol Ann Matheson, PH.D.
• Ann Marie Mathew, NP
• Daniel Thomas Mathew, MD
• Preethy Koothur Mathew, NP
• Roshin C Mathew, M.D.
• Saju I Mathew, MD
• Santhra Sebastian Mathew, DO
• Shobi Mathew

• Acute Care Nurse Practitioner in Atlanta, GA
• Providers in Atlanta, GA by specialty
• Acute Care Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2020; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.