Individual provider Active NPI

Joyce Mathai, PA-C

  • Physician Assistant
  • Soddy Daisy, TN
National Provider Identifier
1871353185
Registry record updated Apr 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
5912 Issued in TN
Practice address
9389 Dayton Pike
#05694
Soddy Daisy, TN 37379-4824
Phone
(225) 757-1023
NPI assigned
Mar 21, 2024
Last updated
Apr 4, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 4, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 5912 TN Primary

Addresses

Primary practice location

9389 Dayton Pike
#05694
Soddy Daisy, TN 37379-4824

Mailing address

6617 Vaden Dr
Chattanooga, TN 37421-2437
Phone (423) 710-4565

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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
I20240530000076 TN Practitioner - Physician Assistant 8527400027 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Minuteclinic Diagnostic of Tennessee PCGroup PAC ID 2961428990, 82 clinicians

Practice addresses (Care Compare)

1200 Gallatin Pike S
Madison, TN 37115-4613
Phone (866) 389-2727

796 Ridgeway Ave
Signal Mountain, TN 37377-3067
Phone (866) 389-2727

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
5912TNMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Privia Medical Group Tennessee LLC Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1710979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712188800000",
    "number": "1871353185",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6617 VADEN DR",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374212437",
            "telephone_number": "423-710-4565"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9389 DAYTON PIKE",
            "address_2": "#05694",
            "city": "SODDY DAISY",
            "state": "TN",
            "postal_code": "373794824",
            "telephone_number": "225-757-1023"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATHAI",
        "first_name": "JOYCE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-03-21",
        "last_updated": "2024-04-04",
        "certification_date": "2024-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TN",
            "license": "5912",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Soddy Daisy, TN

Sources for this page

Verify at the official NPI Registry.