NPIMap

Individual provider Active NPI

Jacob Mathew, MD

  • Internal Medicine Physician
  • Bremerton, WA
National Provider Identifier
1710141346
Registry record updated Jul 31, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD60277434 Issued in WA
Practice address
2720 Clare Ave
Suite a
Bremerton, WA 98310-3374
Phone
(360) 479-6154
Fax
(360) 479-5728
NPI assigned
Jul 14, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2012

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Internal Medicine Physician 207R00000X ME99988 FL
Internal Medicine Physician 207R00000X MD60277434 WA Primary

Addresses

Primary practice location

2720 Clare Ave
Suite a
Bremerton, WA 98310-3374

Mailing address

2520 Cherry Ave
Bremerton, WA 98310-4229
Phone (360) 479-6154

Other identifiers 1

IdentifierTypeStateIssuer
001333300MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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
I20120620000645 WA Practitioner - Hematology/Oncology 8426194051 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Hematology/Oncology
Education
Rush Medical College of Rush University, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Franciscan Medical GroupGroup PAC ID 0547173866, 1,400 clinicians

Practice addresses (Care Compare)

1900 NW Myhre Rd
Silverdale, WA 98383-7662
Phone (564) 240-3100

Hospital & facility affiliations

  • Centerwell Home Health Home health agency, Silverdale, WA, CCN 507106
  • St Michael Medical Center Hospital, Silverdale, WA, CCN 500039
  • St Joseph Medical Center Hospital, Tacoma, WA, CCN 500108
  • Jefferson Healthcare Hospital, Port Townsend, WA, CCN 501323
  • Olympic Medical Center Hospital, Port Angeles, WA, CCN 500072

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD60277434WAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Franciscan Medical Group Internal Medicine CurrentSince Jul 2, 2017 Accepting new patients
Franciscan Medical Group Current Accepting new patients
Harrison Medical Center Past Accepting new patients
Franciscan Medical Group Past Accepting new patients

Locations

2520 Cherry Ave
Bremerton, WA 98310
Phone (360) 377-3911

2720 Clare Ave
Ste A
Bremerton, WA 98310
Phone (360) 479-6154

1900 NW Myhre Rd
Silverdale, WA 98383
Phone (564) 240-3100

9633 Levin Rd NW
Ste 103
Silverdale, WA 98383
Phone (360) 337-8200

1812 S J St
Ste 120
Tacoma, WA 98405
Phone (253) 428-2200

Organizations & group practices 4

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 9

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

NPI Registry JSON

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

{
    "created_epoch": "1215993600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1343692800000",
    "number": "1710141346",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2520 CHERRY AVE",
            "city": "BREMERTON",
            "state": "WA",
            "postal_code": "983104229",
            "telephone_number": "360-479-6154",
            "fax_number": "360-479-5728"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2720 CLARE AVE",
            "address_2": "SUITE A",
            "city": "BREMERTON",
            "state": "WA",
            "postal_code": "983103374",
            "telephone_number": "360-479-6154",
            "fax_number": "360-479-5728"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATHEW",
        "first_name": "JACOB",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-07-14",
        "last_updated": "2012-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME99988",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WA",
            "license": "MD60277434",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001333300",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bremerton, WA

Sources for this page

Verify at the official NPI Registry.