NPIMap

Individual provider Active NPI

Mathew Mathew, MD

  • Internal Medicine Physician
  • Conshohocken, PA
National Provider Identifier
1861473985
Registry record updated May 9, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD052705 Issued in PA
Practice address
1 W Elm St
2ND Floor
Conshohocken, PA 19428-2007
Phone
(610) 567-6964
Fax
(610) 567-6170
NPI assigned
Nov 7, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 9, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD052705 PA Primary

Addresses

Primary practice location

1 W Elm St
2ND Floor
Conshohocken, PA 19428-2007

Mailing address

501 S 54TH St
Philadelphia, PA 19143-1900
Phone (215) 748-9707

Other identifiers 7

IdentifierTypeStateIssuer
0014995650016MedicaidPA
2507506OtherPAAETNA HMO
542595OtherPABLUE SHIELD
5971005OtherPAAETNA PPO
0738814000OtherPAKEYSTONE HEALTH PLAN EAST
1094297OtherPAKMHP
7676599003OtherPACIGNA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040116000110 PA Practitioner - Internal Medicine 6002717741 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Inhospital Physicians CorpGroup PAC ID 3779888110, 24 clinicians

Practice addresses (Care Compare)

2701 Dekalb Pike
East Norriton, PA 19401-1820
Phone (484) 965-9566

Hospital & facility affiliations

  • Roxborough Memorial Hospital Hospital, Philadelphia, PA, CCN 390304
  • Temple University Hospital Hospital, Philadelphia, PA, CCN 390027

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD052705PAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Inhospital Physicians Corp Internal Medicine CurrentSince Dec 27, 2017 Accepting new patients
Prime Healthcare Services-Suburban Hospital LLC Past Accepting new patients
Prime Healthcare Services Roxborough LLC Past Accepting new patients

Locations

610 Sentry Pkwy
Bldg 660
Blue Bell, PA 19422

2701 DeKalb Pike
Norristown, PA 19401
Phone (215) 335-6000

5800 Ridge Ave
Philadelphia, PA 19128
Phone (215) 487-4334

Organizations & group practices 3

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 9

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": "1131321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1210291200000",
    "number": "1861473985",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 S 54TH ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191431900",
            "telephone_number": "215-748-9707",
            "fax_number": "215-748-9708"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 W ELM ST",
            "address_2": "2ND FLOOR",
            "city": "CONSHOHOCKEN",
            "state": "PA",
            "postal_code": "194282007",
            "telephone_number": "610-567-6964",
            "fax_number": "610-567-6170"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATHEW",
        "first_name": "MATHEW",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-07",
        "last_updated": "2008-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MD052705",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0014995650016",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA HMO",
            "identifier": "2507506",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "542595",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA PPO",
            "identifier": "5971005",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KEYSTONE HEALTH PLAN EAST",
            "identifier": "0738814000",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KMHP",
            "identifier": "1094297",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "7676599003",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Conshohocken, PA

Sources for this page

Verify at the official NPI Registry.