NPIMap

Organization Active NPI

Shaji Mathew MD., P.C.

  • Pediatrics Physician
  • Reno, NV
National Provider Identifier
1720276587
Registry record updated Oct 5, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
SHAJI MATHEW MD., P.C.
Practice address
3639 Warren Way
Suite #100
Reno, NV 89509
Phone
(775) 827-3639
Fax
(775) 827-3638
NPI assigned
Oct 5, 2007
Last updated
Oct 5, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 5, 2007

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

Authorized official

Name
Dr. Shaji O Mathew, MD., PHD.
Title
Owner
Phone
(775) 827-3639

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208000000X Primary

Addresses

Primary practice location

3639 Warren Way
Suite #100
Reno, NV 89509

Mailing address

3639 Warren Way
Suite #100
Reno, NV 89509
Phone (775) 827-3639

National Provider Directory

National Provider Directory

Locations

3639 Warren Way
Ste 100
Reno, NV 89509
Phone (775) 827-3639

6350 Mae Anne Ave
Ste 2
Reno, NV 89523

6350 Mae Anne Ave
Ste 3
Reno, NV 89523
Phone (775) 624-6350

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1191542400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1191542400000",
    "number": "1720276587",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3639 WARREN WAY",
            "address_2": "SUITE #100",
            "city": "RENO",
            "state": "NV",
            "postal_code": "89509",
            "telephone_number": "775-827-3639",
            "fax_number": "775-827-3638"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3639 WARREN WAY",
            "address_2": "SUITE #100",
            "city": "RENO",
            "state": "NV",
            "postal_code": "89509",
            "telephone_number": "775-827-3639",
            "fax_number": "775-827-3638"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHAJI MATHEW MD., P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-05",
        "last_updated": "2007-10-05",
        "status": "A",
        "authorized_official_last_name": "MATHEW",
        "authorized_official_first_name": "SHAJI",
        "authorized_official_middle_name": "O",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "775-827-3639",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD., PHD."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Reno, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2007; 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.