Individual provider Active NPI

Nalin Mathur, MD PA

  • Internal Medicine Physician
  • Waldorf, MD
National Provider Identifier
1891791935
Registry record updated Sep 27, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
D52289 Issued in MD
Practice address
11855 Holly Lane
#107
Waldorf, MD 20601-3114
Phone
(301) 638-2733
Fax
(301) 638-3377
NPI assigned
Jun 23, 2005
Last updated
Sep 27, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2012

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 D52289 MD Primary

Addresses

Primary practice location

11855 Holly Lane
#107
Waldorf, MD 20601-3114

Mailing address

PO Box 7436
Alexandria, VA 22307-0436
Phone (301) 638-2733

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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
I20060928000143 MD Practitioner - Internal Medicine 1951306869 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

11855 Holly LN
Waldorf, MD 20601-3114
Phone (301) 638-2733

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions38

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
D52289MDMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Nalin Mathur MD PA Internal Medicine CurrentSince Jan 12, 2010 Accepting new patients
Jayanthan.M.D.,P.a Internal Medicine Past Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

11855 Holly Ln
Ste 107
Waldorf, MD 20601
Phone (301) 638-2733

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

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": "1119484800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1348704000000",
    "number": "1891791935",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7436",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223070436",
            "telephone_number": "301-638-2733",
            "fax_number": "301-638-3377"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11855 HOLLY LANE",
            "address_2": "#107",
            "city": "WALDORF",
            "state": "MD",
            "postal_code": "206013114",
            "telephone_number": "301-638-2733",
            "fax_number": "301-638-3377"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATHUR",
        "first_name": "NALIN",
        "credential": "MD PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-23",
        "last_updated": "2012-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MD",
            "license": "D52289",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waldorf, MD

Sources for this page

Verify at the official NPI Registry.