Active NPI
Mathew David
- Licensed Practical Nurse
- Jamaica, NY
National Provider Identifier
1669772844
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Licensed Practical Nurse
- License
- 303077
- Practice address
- 16937 144TH Rd
Jamaica, NY 11434-5929 - Phone
- (718) 978-7221
- NPI assigned
- Oct 22, 2010
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Licensed Practical Nurse | 164W00000X | 303077 | NY | Primary |
Addresses
Primary practice location
16937 144TH Rd
Jamaica, NY 11434-5929
Mailing address
21 Northfield Ave
Staten Island, NY 10303-1624
Phone (718) 644-8236
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 303077 | NY | MD | Licensed Practical Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1287705600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1287705600000",
"number": "1669772844",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "21 NORTHFIELD AVE",
"city": "STATEN ISLAND",
"state": "NY",
"postal_code": "103031624",
"telephone_number": "718-644-8236"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "16937 144TH RD",
"city": "JAMAICA",
"state": "NY",
"postal_code": "114345929",
"telephone_number": "718-978-7221"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVID",
"first_name": "MATHEW",
"name_prefix": "Mr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2010-10-22",
"last_updated": "2010-10-22",
"status": "A"
},
"taxonomies": [
{
"code": "164W00000X",
"taxonomy_group": "",
"desc": "Licensed Practical Nurse",
"state": "NY",
"license": "303077",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jamaica, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.