Individual provider Active NPI

Stephen Thomas Mathai, MD

  • Pediatrics Physician
  • Dayton, OH
National Provider Identifier
1952404105
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
35048185 Issued in OH
Practice address
25 Thorpe Dr
Dayton, OH 45420-1823
Phone
(937) 258-6330
Fax
(937) 252-1242
NPI assigned
Sep 6, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 35048185 OH Primary

Addresses

Primary practice location

25 Thorpe Dr
Dayton, OH 45420-1823

Mailing address

1780 Valleybrook PL
Centerville Finance, OH 45459-5151
Phone (937) 433-2932

Other identifiers 1

IdentifierTypeStateIssuer
0496379MedicaidOH

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)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
35048185OHMDPediatrics Physician

NPI Registry JSON

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

{
    "created_epoch": "1157500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1952404105",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1780 VALLEYBROOK PL",
            "city": "CENTERVILLE FINANCE",
            "state": "OH",
            "postal_code": "454595151",
            "telephone_number": "937-433-2932",
            "fax_number": "937-252-1242"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 THORPE DR",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454201823",
            "telephone_number": "937-258-6330",
            "fax_number": "937-252-1242"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATHAI",
        "first_name": "STEPHEN",
        "middle_name": "THOMAS",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-06",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "OH",
            "license": "35048185",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0496379",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dayton, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.