Mathura Medical Group Inc

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

MATHURA MEDICAL GROUP INC

Practice address

110 Pond CT Ste 203
Debary, FL 32713-2717

Phone

(386) 259-4106

Fax

(866) 554-1654

NPI assigned

Jun 7, 2021

Organization subpart

No

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

Authorized official

Name

Dr. Shiva A Mathura, MDNPI 1912247719

Title

Owner

Phone

(386) 259-4106

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Shiva A Mathura, MD

  • Family Medicine Physician
  • Debary, FL
  • NPI 1912247719
  Medicare reassignment NPD Authorized official
• Judith Del Carmen Mathura, M.D.

  • Family Medicine Physician
  • Debary, FL
  • NPI 1609211069
  Medicare reassignment NPD

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

{
    "created_epoch": "1623024000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1687910400000",
    "number": "1871160960",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 POND CT STE 203",
            "city": "DEBARY",
            "state": "FL",
            "postal_code": "327132717",
            "telephone_number": "386-259-4106",
            "fax_number": "866-554-1654"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 POND CT STE 203",
            "city": "DEBARY",
            "state": "FL",
            "postal_code": "327132717",
            "telephone_number": "386-259-4106",
            "fax_number": "866-554-1654"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MATHURA MEDICAL GROUP INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-06-07",
        "last_updated": "2023-06-28",
        "certification_date": "2023-06-28",
        "status": "A",
        "authorized_official_last_name": "MATHURA",
        "authorized_official_first_name": "SHIVA",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "386-259-4106",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gail Maine
• Sage Mikayla Maiolo, DC
• Frank Mari, MD
• Manuela C Marin, LMHC
• Michelle Marpole
• Judith Del Carmen Mathura, M.D.
• Shiva A Mathura, MD
• Vincent T Mattiello, DC
• Emily Maza
• Ryan Patrick McNeel, DC

• Family Medicine Physician in Debary, FL
• Providers in Debary, FL by specialty
• Family Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.