Susamma Mathew, MD

Primary specialty

SpecialistTaxonomy code 174400000X

License

045881 Issued in GA

Practice address

3525 Sugarloaf Pkwy
Lawrenceville, GA 30044-5403

Phone

(678) 377-1113

Fax

(678) 377-9390

NPI assigned

Jul 19, 2005

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: susamma.mathew@gadirect.net

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Sugarloaf Pediatrics, PC

  • Primary Care Clinic/Center
  • Lawrenceville, GA
  • NPI 1134297799
  NPD (past)

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

{
    "created_epoch": "1121731200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1298419200000",
    "number": "1942209259",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3525 SUGARLOAF PKWY",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300445403",
            "telephone_number": "678-377-1113",
            "fax_number": "678-377-9390"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3525 SUGARLOAF PKWY",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300445403",
            "telephone_number": "678-377-1113",
            "fax_number": "678-377-9390"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATHEW",
        "first_name": "SUSAMMA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-07-19",
        "last_updated": "2011-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "GA",
            "license": "045881",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00797057B",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Benita Merin Mathew, CAA
• Jayce Mathew, DDS
• Jose Mathew, DO, MPH
• Lekha Mathew, MD
• Sheba Ann Mathew
• Taniya Mathew, MD
• Bridget Kathleen Mathews, PT, DPT
• Mia M Mathewson, M.D.
• Kendia Mathieu
• Heather Mathis, LPC

• Specialist in Lawrenceville, GA
• Providers in Lawrenceville, GA by specialty
• Specialist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2011; 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.