Jacob Muthalaly Mathew, M.D.

Primary specialty

Interventional Cardiology PhysicianTaxonomy code 207RI0011X

License

E-7924 Issued in AR

Practice address

1970 Roanoke Blvd
Department of Cardiology
Salem, VA 24153-6404

Phone

(540) 982-2463

NPI assigned

Jul 27, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in VA, NC2 enrollments

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 2

Specialty

Cardiovascular Disease (Cardiology)

Education

Other, 2000

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

DLP Western Carolina Physician Practices LLCGroup PAC ID 9032338975, 177 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Haywood Regional Medical Center Hospital, Clyde, NC, CCN 340184

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine

State licenses

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 and National Provider Directory roles.

• DLP Western Carolina Physician Practices LLC

  • Internal Medicine Physician
  • Sylva, NC
  • NPI 1609281641
  Medicare reassignment Care Compare group NPD
• Ingleside Physician Services, LLC

  • Hospitalist Physician
  • Low Moor, VA
  • NPI 1932693488
  Medicare reassignment NPD
• The Moses H. Cone Memorial Hospital Operating Corporation

  • Internal Medicine Physician
  • Greensboro, NC
  • NPI 1013265909
  Medicare reassignment NPD
• DLP Western Carolina Physician Practices LLC

  • Diagnostic Radiology Physician
  • Clyde, NC
  • NPI 1932925062
  NPD
• The Moses H Cone Memorial Hospital Operating Corporation

  • Community/Retail Pharmacy
  • Eden, NC
  • NPI 1861222507
  NPD
• The Moses H. Cone Memorial Hospital Operating Corporation

  • Family Medicine Physician
  • Elon, NC
  • NPI 1558063958
  NPD
• Community Hospitalist Medical Group Inc.

  • Internal Medicine Physician
  • Fresno, CA
  • NPI 1467437376
  NPD (past)
• Sante Health Foundation

  • Internal Medicine Physician
  • Fresno, CA
  • NPI 1376840546
  NPD (past)

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

• DLP Haywood Regional Medical Center LLC.

  • General Acute Care Hospital
  • Clyde, NC
  • NPI 1811158215
  Care Compare affiliation

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

{
    "created_epoch": "1185494400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1416182400000",
    "number": "1710177506",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1970 ROANOKE BLVD",
            "address_2": "DEPARTMENT OF CARDIOLOGY",
            "city": "SALEM",
            "state": "VA",
            "postal_code": "241536404",
            "telephone_number": "540-982-2463"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1970 ROANOKE BLVD",
            "address_2": "DEPARTMENT OF CARDIOLOGY",
            "city": "SALEM",
            "state": "VA",
            "postal_code": "241536404",
            "telephone_number": "540-982-2463"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATHEW",
        "first_name": "JACOB",
        "middle_name": "MUTHALALY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-07-27",
        "last_updated": "2014-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "125-053685",
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "AR",
            "license": "E-7924",
            "primary": true
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "CA",
            "license": "A111744",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kimberly Charise Martin, NP-C
• Matthew Santos Martinez
• Christin Nicole Martino, MD
• Rachel Mash, DPT
• Katerina Vladimir Mastronardi, DO
• Diana Mathews, BCBA
• James D. Matthews, M.D.
• Ryan Keith Mattocks, LPC
• Mary H Mattox, LPN
• Jasbir Mavi, M.D.

• Interventional Cardiology Physician in Salem, VA
• Providers in Salem, VA by specialty
• Interventional Cardiology Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2014; 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.