NPIMap

Organization Active NPI

Owen R. Mathieu, Jr., M.D., P.C.

  • Specialist
  • Salem, MA
National Provider Identifier
1669686283
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
OWEN R. MATHIEU, JR., M.D., P.C.
Practice address
100 Highland Avenue
Suite 202
Salem, MA 01970
Phone
(978) 740-0634
NPI assigned
May 10, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Owen R. Mathieu Jr., M.D.NPI 1881750982
Title
President
Phone
(978) 740-0634

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X Primary

Addresses

Primary practice location

100 Highland Avenue
Suite 202
Salem, MA 01970

Mailing address

100 Highland Avenue
Suite 202
Salem, MA 01970
Phone (978) 740-0634

Other identifiers 1

IdentifierTypeStateIssuer
9703756MedicaidMA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1178755200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1669686283",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 HIGHLAND AVENUE",
            "address_2": "SUITE 202",
            "city": "SALEM",
            "state": "MA",
            "postal_code": "01970",
            "telephone_number": "978-740-0634"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 HIGHLAND AVENUE",
            "address_2": "SUITE 202",
            "city": "SALEM",
            "state": "MA",
            "postal_code": "01970",
            "telephone_number": "978-740-0634"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OWEN R. MATHIEU, JR., M.D., P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-10",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MATHIEU",
        "authorized_official_first_name": "OWEN",
        "authorized_official_middle_name": "R.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "978-740-0634",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9703756",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Salem, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.