Individual provider Active NPI

Jose Mathew, DO, MPH

  • Pain Medicine (Physical Medicine & Rehabilitation) Physician
  • Lawrenceville, GA
National Provider Identifier
1861654659
Registry record updated Jan 5, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081P2900X
License
66218 Issued in GA
Practice address
455 Philip Blvd Ste 140
Lawrenceville, GA 30046-8768
Phone
(770) 962-3642
Fax
(770) 962-3643
NPI assigned
Jul 2, 2008
Last updated
Jan 5, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine (Physical Medicine & Rehabilitation) Physician 2081P2900X 66218 GA Primary

Addresses

Primary practice location

455 Philip Blvd Ste 140
Lawrenceville, GA 30046-8768

Mailing address

455 Philip Blvd Ste 140
Lawrenceville, GA 30046-8768
Phone (770) 962-3642

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120111000971 GA Practitioner - Physical Medicine and Rehabilitation 7810176047 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Medicine and Rehabilitation
Education
Other, 2006
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices
Georgia Pain and Wellness CenterGroup PAC ID 8527200864, 53 clinicians

Practice addresses (Care Compare)

1200 Bald Ridge Marina Rd
Suite 150
Cumming, GA 30041-8526
Phone (770) 962-3642

1357 Hembree Rd
Suite 220
Roswell, GA 30076-5722
Phone (770) 962-3642

1504 N Thornton Ave
Suite 103
Dalton, GA 30720-8394
Phone (770) 962-3642

1780 Oak Rd
Suite A2
Snellville, GA 30078-2206
Phone (770) 962-3642

314 N Broad St
Suite 210
Winder, GA 30680-2163
Phone (770) 962-3642

455 Philip Blvd
Suite 140
Lawrenceville, GA 30046-8768
Phone (770) 962-3642

484 Irvin CT
Suite 110
Decatur, GA 30030-5406
Phone (770) 962-3642

526 Bankhead Hwy
Suite 101
Carrollton, GA 30117-2463
Phone (770) 962-3642

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
80.28 of 100Reported as group
Quality
75.54
Promoting interoperability
87
Improvement activities
40
Cost
55.81

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
66218GAMDPain Medicine (Physical Medicine & Rehabilitation) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Georgia Pain and Wellness Center CurrentSince Aug 1, 2016 Accepting new patients
Georgia Pain and Wellness Center CurrentSince Aug 1, 2016 Accepting new patients
Urology Centers of Alabama PC Past Accepting new patients
Georgia Interventional Pain - D LLC PastSince Mar 1, 2017 Accepting new patients
Sleep Ezzy PastSince Mar 5, 2019 Accepting new patients
Minimally Invasive Neurospine and Pain Institute, P.C. Past Accepting new patients
Minimally Invasive Neurospine and Pain Institute, PC Past Accepting new patients
South Atlanta Neurosurgery Past Accepting new patients
Georgia Pain and Wellness Center, LLC Past Accepting new patients

Locations

1255 Friendship Rd
Ste 150
Braselton, GA 30517

100 Liberty Blvd
Ste 210
Canton, GA 30114

1501 Milstead Rd NE
Ste 190
Conyers, GA 30012
Phone (770) 760-9900

1200 Bald Ridge Marina Rd
Ste 150
Cumming, GA 30041
Phone (770) 886-0003

1504 N Thornton Ave
Ste 103
Dalton, GA 30720
Phone (706) 278-5275

484 Irvin Ct
Ste 110
Decatur, GA 30030
Phone (404) 292-4057

1485 Jesse Jewell Pkwy NE
Ste 310
Gainesville, GA 30501

49 Gordon Rd
Jasper, GA 30143
Phone (678) 878-2555

455 Philip Blvd
Ste 140
Lawrenceville, GA 30046
Phone (787) 618-5889

7660 Covington Hwy
Lithonia, GA 30058
Phone (770) 482-2964

39 Oak Hill Ct
Ste 101
Newnan, GA 30265

39C Oak Hill Ct
Ste 101
Newnan, GA 30265

146 Smitherman Rd
Ringgold, GA 30736
Phone (423) 667-3225

1357 Hembree Rd
Ste 220
Roswell, GA 30076

1780 Oak Rd
Ste A2
Snellville, GA 30078
Phone (678) 344-0050

830 Eagles Landing Pkwy
Ste 204
Stockbridge, GA 30281

314 N Broad St
Ste 210
Winder, GA 30680
Phone (770) 267-1159

203 Woodpark Pl
Ste B102
Woodstock, GA 30188
Phone (770) 926-0021

Organizations & group practices 9

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 5

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": "1214956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1515110400000",
    "number": "1861654659",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "455 PHILIP BLVD STE 140",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300468768",
            "telephone_number": "770-962-3642",
            "fax_number": "770-962-3643"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "455 PHILIP BLVD STE 140",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300468768",
            "telephone_number": "770-962-3642",
            "fax_number": "770-962-3643"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATHEW",
        "first_name": "JOSE",
        "name_prefix": "Dr.",
        "credential": "DO, MPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-07-02",
        "last_updated": "2018-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2081P2900X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": "GA",
            "license": "66218",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lawrenceville, GA

Sources for this page

Verify at the official NPI Registry.