Individual provider Active NPI

Tina M. Mathew, APN-CNP

  • Nurse Practitioner
  • Arlington Heights, IL
National Provider Identifier
1730699778
Registry record updated Jul 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
209016559 Issued in IL
Practice address
880 W Central Rd Ste 5000
Arlington Heights, IL 60005-2384
Phone
(847) 618-3800
Fax
(847) 618-3809
NPI assigned
Oct 4, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 209016559 IL Primary

Addresses

Primary practice location

880 W Central Rd Ste 5000
Arlington Heights, IL 60005-2384

Mailing address

880 W Central Rd Ste 5000
Arlington Heights, IL 60005-2384
Phone (847) 618-3800

Other names 1

  • Tina M Thomas Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180119001416 IL Practitioner - Nurse Practitioner 1951660927 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Endeavor Health Medical GroupGroup PAC ID 2163334699, 3,330 clinicians

Practice addresses (Care Compare)

880 W Central Rd
Arlington Heights, IL 60005-2355
Phone (847) 483-9400

Hospital & facility affiliations

  • Northwest Community Hospital 1 Hospital, Arlington Heights, IL, CCN 140252
  • Loyola University Medical Center Hospital, Maywood, IL, CCN 140276

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
209016559ILMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Endeavor Health Medical Group CurrentSince Jul 1, 2024 Accepting new patients
Endeavor Health Medical Group Current Accepting new patients
Loyola University Medical Center Current Accepting new patients
Advocate Health and Hospitals Corporation CurrentSince Dec 8, 2017 Accepting new patients
Advocate Health and Hospitals Corporation CurrentSince Dec 8, 2017 Accepting new patients

Locations

880 W Central Rd
Ste 5000
Arlington Heights, IL 60005
Phone (847) 618-3800

880 W Central Rd
Arlington Hts, IL 60005
Phone (847) 394-3553

214 McHenry Rd
Buffalo Grove, IL 60089
Phone (847) 459-1160

29373 Network Pl
Chicago, IL 60673

9532 Eagle Way
Chicago, IL 60678

2650 Ridge Ave
Ste 2218A
Evanston, IL 60201
Phone (847) 503-4222

2650 Ridge Ave
Evanston, IL 60201
Phone (847) 570-1206

2650 Ridge Ave
Ste 1223
Evanston, IL 60201
Phone (847) 982-3175

660 N Westmoreland Rd
#302
Lake Forest, IL 60045

2160 S 1st Ave
Maywood, IL 60153
Phone (708) 216-4400

100 W 162nd St
South Holland, IL 60473
Phone (708) 730-2200

Interoperability endpoints

  • Direct secure messaging: tmathew95005@direct.luhs.org
  • Direct secure messaging: tmathew169002@direct.nch.org

Organizations & group practices 5

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 4

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": "1507075200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721174400000",
    "number": "1730699778",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "880 W CENTRAL RD STE 5000",
            "city": "ARLINGTON HEIGHTS",
            "state": "IL",
            "postal_code": "600052384",
            "telephone_number": "847-618-3800",
            "fax_number": "847-618-3809"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "880 W CENTRAL RD STE 5000",
            "city": "ARLINGTON HEIGHTS",
            "state": "IL",
            "postal_code": "600052384",
            "telephone_number": "847-618-3800",
            "fax_number": "847-618-3809"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATHEW",
        "first_name": "TINA",
        "middle_name": "M.",
        "credential": "APN-CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-10-04",
        "last_updated": "2024-07-17",
        "certification_date": "2024-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209016559",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TINA",
            "last_name": "THOMAS",
            "middle_name": "M",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Arlington Heights, IL

Sources for this page

Verify at the official NPI Registry.