NPIMap

Individual provider Active NPI

Jose Mathew, MD

  • Cardiovascular Disease Physician
  • Leesville, LA
National Provider Identifier
1699744987
Registry record updated Jan 23, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
11538R Issued in LA
Practice address
1101 Port Arthur Ter
Leesville, LA 71446-4635
Phone
(337) 392-2211
Fax
(337) 392-2210
NPI assigned
Mar 17, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 23, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 11538R LA Primary

Addresses

Primary practice location

1101 Port Arthur Ter
Leesville, LA 71446-4635

Mailing address

1101 Port Arthur Ter
Leesville, LA 71446-4635
Phone (337) 238-1517

Other identifiers 3

IdentifierTypeStateIssuer
11538ROtherLASTATE LICENSE
1675024MedicaidLA
P00225923OtherLARAILROAD MEDICARE #

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050811000040 LA Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 2264461110 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)Also: Internal Medicine
Education
Other, 1979
Medicare assignment
May accept Medicare assignment
Group practices
Physical Therapy Services of West Louisiana IncGroup PAC ID 0446388763, 92 clinicians

Practice addresses (Care Compare)

1101 A Port Arthur Ter
Leesville, LA 71446-4635
Phone (337) 392-2211

301 W Fertitta Blvd
Suite 4
Leesville, LA 71446-4665
Phone (337) 238-9931

Hospital & facility affiliations

  • Vernon Home Health Home health agency, Leesville, LA, CCN 197413
  • Elara Caring Home health agency, Leesville, LA, CCN 197260
  • Byrd Regional Hospital Hospital, Leesville, LA, CCN 190164
  • Beauregard Memorial Hospital Hospital, Deridder, LA, CCN 190050
  • Christus Ochsner St Patrick Hospital Hospital, Lake Charles, LA, CCN 190027
  • Sabine Medical Center Hospital, Many, LA, CCN 190218
  • Christus St Frances Cabrini Hospital Hospital, Alexandria, LA, CCN 190019

Merit-based Incentive Payment System (MIPS)

Final score
87.31 of 100Reported as individual
Quality
90.25
Improvement activities
40
Cost
55.56

Procedures performed for Medicare patients

ProcedureNumber of procedures
Pacemaker insertion or repair1-10
Varicose vein removal1-10
Leg revascularization (restoring blood flow)1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
11538RLAMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Leesville Cardiovascular Center Inc Cardiovascular Disease CurrentSince Jul 1, 2005 Accepting new patients
CLHG-Leesville Past Accepting new patients

Locations

1101 Port Arthur Ter
#A
Leesville, LA 71446
Phone (318) 238-4793

1020 W Fertitta Blvd
Leesville, LA 71446
Phone (337) 239-5278

1101 Port Arthur Ter
Leesville, LA 71446
Phone (318) 238-9088

1101A Port Arthur Ter
Leesville, LA 71446
Phone (318) 238-4793

Interoperability endpoints

  • Direct secure messaging: jose.mathew@lcc.eclinicaldirectplus.com
  • FHIR API: https://fhir4.healow.com/fhir/r4/GJADAA
  • Direct secure messaging: brhjmathe@yourcarecommunity.org
  • FHIR API: https://fhir4.healow.com/fhir/r4/GJADAA/Endpoint/GJADAA

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Vernon Home HealthLeesville, LA, CCN 197413 Home health agency 5% Or Greater Direct Ownership Interest (11.5%) Oct 1, 2007

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

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 29

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

View all 29

NPI Registry JSON

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

{
    "created_epoch": "1142553600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1390435200000",
    "number": "1699744987",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1101 PORT ARTHUR TER",
            "city": "LEESVILLE",
            "state": "LA",
            "postal_code": "714464635",
            "telephone_number": "337-238-1517"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 PORT ARTHUR TER",
            "city": "LEESVILLE",
            "state": "LA",
            "postal_code": "714464635",
            "telephone_number": "337-392-2211",
            "fax_number": "337-392-2210"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATHEW",
        "first_name": "JOSE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-03-17",
        "last_updated": "2014-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "LA",
            "license": "11538R",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "11538R",
            "state": "LA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1675024",
            "state": "LA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE #",
            "identifier": "P00225923",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Leesville, LA

Sources for this page

Verify at the official NPI Registry.