Individual provider Active NPI

Alexander T Mathew, OTR/L

  • Occupational Therapist
  • Mount Kisco, NY
National Provider Identifier
1902208242
Registry record updated Nov 27, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
025243 Issued in NY
Practice address
101 S Bedford Rd
Mount Kisco, NY 10549-3439
Phone
(914) 373-6823
NPI assigned
Sep 18, 2014
Reactivated
Nov 24, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X 008413-1 NY
Occupational Therapist 225X00000X 025243 NY Primary

Addresses

Primary practice location

101 S Bedford Rd
Mount Kisco, NY 10549-3439

Mailing address

21 Judith St
Nanuet, NY 10954-2413
Phone (845) 269-1288

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
008413-1NYMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1410998400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606435200000",
    "number": "1902208242",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21 JUDITH ST",
            "city": "NANUET",
            "state": "NY",
            "postal_code": "109542413",
            "telephone_number": "845-269-1288",
            "fax_number": "845-651-2258"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 S BEDFORD RD",
            "city": "MOUNT KISCO",
            "state": "NY",
            "postal_code": "105493439",
            "telephone_number": "914-373-6823"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATHEW",
        "first_name": "ALEXANDER",
        "middle_name": "T",
        "name_prefix": "Mr.",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-09-18",
        "last_updated": "2020-11-27",
        "certification_date": "2020-11-27",
        "deactivation_date": "2020-11-19",
        "reactivation_date": "2020-11-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "NY",
            "license": "008413-1",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NY",
            "license": "025243",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Kisco, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.