Individual provider Active NPI

Babu Paul Mattam, M.D.

  • Internal Medicine Physician
  • Huntington, WV
National Provider Identifier
1922047240
Registry record updated Mar 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
222480 Issued in NY
Practice address
1540 Spring Valley Drive
Huntington, WV 25704
Phone
(304) 429-6741
Fax
(304) 429-0262
NPI assigned
Jun 5, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 12, 2025

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 222480 NY Primary

Addresses

Primary practice location

1540 Spring Valley Drive
Huntington, WV 25704

Mailing address

1540 Spring Valley Drive
Huntington, WV 25704
Phone (304) 429-6741

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV
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
I20141217002503 WV Order and Referring Only - Internal MedicinePractitioner - Internal Medicine 8628265485

National Provider Directory

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

NPI Registry JSON

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

{
    "created_epoch": "1149465600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741737600000",
    "number": "1922047240",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1540 SPRING VALLEY DRIVE",
            "city": "HUNTINGTON",
            "state": "WV",
            "postal_code": "25704",
            "telephone_number": "304-429-6741",
            "fax_number": "304-429-0262"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1540 SPRING VALLEY DRIVE",
            "city": "HUNTINGTON",
            "state": "WV",
            "postal_code": "25704",
            "telephone_number": "304-429-6741",
            "fax_number": "304-429-0262"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATTAM",
        "first_name": "BABU",
        "middle_name": "PAUL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-05",
        "last_updated": "2025-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "222480",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Huntington, WV

Sources for this page

Verify at the official NPI Registry.