Individual provider Active NPI

Sara Mathew

  • Pharmacist
  • Bayside, NY
National Provider Identifier
1710755293
Registry record updated Dec 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
071193 Issued in NY
Practice address
21220 Northern Blvd
Bayside, NY 11361-3342
Phone
(718) 281-3223
NPI assigned
Dec 14, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 14, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 071193 NY Primary

Addresses

Primary practice location

21220 Northern Blvd
Bayside, NY 11361-3342

Mailing address

21220 Northern Blvd
Bayside, NY 11361-3342
Phone (718) 281-3223

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

LicenseStateTypeSpecialty
071193NYMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
CVS Albany LLC PastSince Dec 17, 2023 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1702512000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702512000000",
    "number": "1710755293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21220 NORTHERN BLVD",
            "city": "BAYSIDE",
            "state": "NY",
            "postal_code": "113613342",
            "telephone_number": "718-281-3223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21220 NORTHERN BLVD",
            "city": "BAYSIDE",
            "state": "NY",
            "postal_code": "113613342",
            "telephone_number": "718-281-3223"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATHEW",
        "first_name": "SARA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-12-14",
        "last_updated": "2023-12-14",
        "certification_date": "2023-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NY",
            "license": "071193",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bayside, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.