Mary L Mathew, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

117669 Issued in NY

Practice address

1561 Long Pond Rd
Suite 206
Rochester, NY 14626-4117

Phone

(585) 368-4000

Fax

(585) 368-4815

NPI assigned

Jun 27, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

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.

• Rochester General Hospital

  • General Acute Care Hospital
  • Rochester, NY
  • NPI 1063531929
  NPD (past)
• The Unity Hospital of Rochester

  • General Acute Care Hospital
  • Rochester, NY
  • NPI 1457395766
  NPD (past)

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

{
    "created_epoch": "1151366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1481673600000",
    "number": "1740217504",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1561 LONG POND RD",
            "address_2": "SUITE 206",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146264117",
            "telephone_number": "585-368-4000",
            "fax_number": "585-368-4815"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1561 LONG POND RD",
            "address_2": "SUITE 206",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146264117",
            "telephone_number": "585-368-4000",
            "fax_number": "585-368-4815"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATHEW",
        "first_name": "MARY",
        "middle_name": "L",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-27",
        "last_updated": "2016-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "117669",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RR",
            "identifier": "P00318888",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01519653",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Cassandra Matalavage
• Kim Matava
• Jane Matejcik
• Joshua Lindley Mateo
• Edward J Mathes, PHYSICIAN ASSISTANT
• Puthenpurakal K Mathew, MD
• Shylon T Mathew, D.D.S.
• Theckedath Mathew, M.D.
• Vineetha S Mathew, MD
• Ian T Mathews, MD

• Internal Medicine Physician in Rochester, NY
• Providers in Rochester, NY by specialty
• Internal Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2016; 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.