Matty Mathivannan, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

MD31203 Issued in DC

Practice address

2141 K St NW
Suite 606
Washington, DC 20037-1810

Phone

(202) 293-8680

Fax

(202) 293-8694

NPI assigned

Nov 12, 2006

Last updated

Oct 13, 2022By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Ambal Mathivannan Former name

Electronic endpoints 2

Medicare fee-for-service enrollment

Enrolled in DC

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

Specialty

Internal Medicine

Education

Other, 1994

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Kaiser Foundation Health Plan of the Mid Atlantic States, IncGroup PAC ID 3779495858, 1,921 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Kaiser Foundation Health Plan of the Mid Atlantic States, Inc

  dba Kaiser Permanente Annapolis Medical Center

  • Health Maintenance Organization
  • Annapolis, MD
  • NPI 1952461816

  DC, Internal Medicine

  Medicare reassignment Care Compare group NPD
• Medstar Heart Institute LLC

  • Surgery Physician
  • Washington, DC
  • NPI 1528345378
  Medicare reassignment NPD
• Unity Health Care, Inc.

  • Federally Qualified Health Center (FQHC)
  • Washington, DC
  • NPI 1093894172
  Medicare reassignment NPD
• WHC Physician Group LLC

  • General Practice Physician
  • Washington, DC
  • NPI 1700154226
  Medicare reassignment NPD
• Medstar Medical Group II LLC

  • General Practice Physician
  • Baltimore, MD
  • NPI 1184046187

  DC

  Medicare reassignment NPD
• A.Mathivannan PC

  • Internal Medicine Physician
  • Washington, DC
  • NPI 1083894497
  NPD (past) Authorized official
• Kaiser Foundation Health Plan of the Mid Atlantic States, Inc

  dba Kaiser Permanente Capitol Hill Medical Center

  • Health Maintenance Organization
  • Washington, DC
  • NPI 1093016933
  NPD
• Medstar Medical Group II LLC

  • Internal Medicine Physician
  • Washington, DC
  • NPI 1376887844
  NPD
• Unity Health Care Inc.

  dba Unity Health Pharmacy

  • Community/Retail Pharmacy
  • Washington, DC
  • NPI 1346014412
  NPD
• WHC Emerg Phys

  • Emergency Medical Services (Emergency Medicine) Physician
  • Washington, DC
  • NPI 1306260625
  NPD
• Kaiser Foundation Health Plan of the Mid Atlantic States, Inc

  dba Kaiser Permanente Shady Grove Peritoneal Dialysis Facility

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Rockville, MD
  • NPI 1962108753
  NPD
• Whitman-Walker Clinic Inc.

  dba Whitman-Walker Pharmacy

  • Community/Retail Pharmacy
  • Washington, DC
  • NPI 1003316316
  NPD (past)

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

{
    "created_epoch": "1163289600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665619200000",
    "number": "1679644736",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8390 CHAMPIONS GATE BLVD",
            "address_2": "SUITE 215",
            "city": "CHAMPIONS GATE",
            "state": "FL",
            "postal_code": "338968310",
            "telephone_number": "407-390-1677",
            "fax_number": "407-390-1765"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2141 K ST NW",
            "address_2": "SUITE 606",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200371810",
            "telephone_number": "202-293-8680",
            "fax_number": "202-293-8694"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATHIVANNAN",
        "first_name": "MATTY",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-12",
        "last_updated": "2022-10-13",
        "certification_date": "2022-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "DC",
            "license": "MD31203",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "037070700",
            "state": "DC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepiceast.kp.org:14430/Interconnect-prodmam/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq",
            "affiliation": "N",
            "endpointDescription": "Carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "2141 K St NW",
            "address_2": "Suite 606",
            "city": "Washington",
            "state": "DC",
            "country_code": "US",
            "postal_code": "200371810",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepiceast.kp.org:14430/Interconnect-prodmam/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq",
            "affiliation": "N",
            "endpointDescription": "Carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "2141 K St NW",
            "address_2": "Suite 606",
            "city": "Washington",
            "state": "DC",
            "country_code": "US",
            "postal_code": "200371810",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "AMBAL",
            "last_name": "MATHIVANNAN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Ryan Kent Mathis
• Sabrina C Mathis
• Sean E Mathis, PNP
• Tameka Jawanda Mathis
• David J Mathison, M.D., M.B.A.
• Arjun Mathur
• Natasha Mathur
• Raj Pratap Mathur, MD
• Jeevan Mathura, MD
• Jeevan Mathura Jr., MD

• Internal Medicine Physician in Washington, DC
• Providers in Washington, DC by specialty
• Internal Medicine Physician in District of Columbia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2022; 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.