JISHA MARY MATHEW (NPI# 1114114295) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114114295 |
| Entity Type | Individual |
| Full Name | JISHA MARY MATHEW |
| Credential | RPA-C |
| Practice Address |
1065 Southern Blvd Bronx NY 10459-2417 |
| Practice Telephone | 7185892440 |
| Mailing Telephone | 7185892440 |
| Enumeration Date | 2007-10-02 |
| Last Update Date | 2012-05-22 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | 011874 | NY | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NY | LICENSE | 011874 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205478724 | Jisha Mathew | Nurse Practitioner | 2636 High Ridge Dr, Lakeland, FL 33812-5883 | 2019-10-16 |
| 1700377934 | Jisha Merin Mathew | Nurse Practitioner | 1835 Oliver Ave, Apt 4, Valley Stream, NY 11580 | 2018-05-23 |
| Street Address |
1065 SOUTHERN BLVD |
| City | BRONX |
| State | NY |
| Zip Code | 10459-2417 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609872035 | Claude Parola | Internal Medicine | 1065 Southern Blvd, Bronx, NY 10459-2417 | 2005-06-21 |
| 1386243582 | Maribel Luna Cruz | Radiologic Technologist | 1065 Southern Blvd, Bronx, NY 10459-2417 | 2020-10-20 |
| 1669080685 | Anna Katrina Reyes Florendo | Nurse Practitioner | 1065 Southern Blvd, Bronx, NY 10459-2417 | 2020-07-15 |
| 1588280911 | Daniel James Mulcahy | Physician Assistant | 1065 Southern Blvd, Bronx, NY 10459-2417 | 2020-06-22 |
| 1629691142 | Kelly K Smith | Nurse Practitioner | 1065 Southern Blvd, Bronx, NY 10459-2417 | 2020-05-19 |
| 1740813856 | Oresta Victoria Borodevyc | Physician Assistant | 1065 Southern Blvd, Bronx, NY 10459-2417 | 2020-02-17 |
| 1891327557 | Temina A Kusi | Physician Assistant | 1065 Southern Blvd, Bronx, NY 10459-2417 | 2020-02-10 |
| 1780220590 | Maria Feliz | Social Worker | 1065 Southern Blvd, Bronx, NY 10459-2417 | 2019-11-27 |
| 1104460237 | Josiah Guitian | Physician Assistant | 1065 Southern Blvd, Bronx, NY 10459-2417 | 2019-11-01 |
| 1508400938 | Nayary Santana | Social Worker | 1065 Southern Blvd, Bronx, NY 10459-2417 | 2019-10-29 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912508458 | Sterling Smiles LLC | Dentist | 1022 E163rd St, Bronx, NY 10459 | 2020-11-02 |
| 1710496633 | Vitus C. Ezerioha | Licensed Practical Nurse | 870 Southern Blvd., Apt 1a, Bronx, NY 10459 | 2017-09-22 |
| 1790208403 | Jessica S Lee | Early Intervention Provider Agency | 985 Intervale Ave Apt. 2c, Bronx, NY 10459 | 2017-07-25 |
| 1669901070 | Ruthlyn Merrick | Registered Nurse | 1466 Louis Nine Blvd, Bronx, NY 10459 | 2017-06-08 |
| 1154865681 | John Wahl | Speech-Language Pathologist | 977 Fox St., Is 217, Bronx, NY 10459 | 2016-12-19 |
| 1801349675 | Aneesa Ible | Social Worker | 953 Southern Blvd, Suite 301, Odyssey House Inc., Bronx, NY 10459 | 2016-07-28 |
| 1457711277 | Agboade Ademiju | Registered Nurse | 900 Intervale Ave, Archcare, Bronx, Bronx, NY 10459 | 2016-03-07 |
| 1952760076 | Apollo Radio Dispatcher | Taxi | 801 Freeman Street, Bronx, NY 10459 | 2016-02-17 |
| 1730547522 | Foxhurst Medical of New York LLC | Surgery | 947 Southern Blvd Ste B, Bronx, NY 10459 | 2016-02-08 |
| 1063892388 | Vismar Radio Dispatch Inc. | Taxi | 1040-52 Freeman St, Bronx, NY 10459 | 2015-06-02 |
| Find all providers in zip 10459 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982242319 | Leonard Ohene Takyi | Physician Assistant | 4180 Hutchinson River Pkwy E Apt 8c, Bronx, NY 10475-4826 | 2019-12-16 |
| 1669018032 | Natasha Kodua | Physician Assistant | 140 Asch Loop Apt 9e, Bronx, NY 10475-4040 | 2019-11-20 |
| 1073158010 | Abdoulaye Diallo | Physician Assistant | 1223 Tinton Ave Fl 3, Bronx, NY 10456-3673 | 2019-11-13 |
| 1538703954 | Frank Owusu | Physician Assistant | 500 E 165th St Apt 2e, Bronx, NY 10456-6658 | 2019-10-29 |
| 1629534649 | David A Rivera | Physician Assistant | 2105 Cruger Ave Apt 3g, Bronx, NY 10462-2363 | 2019-02-14 |
| 1679037980 | Ryan Patrick Garrow | Physician Assistant | 1200 Waters Pl Ste M108, Bronx, NY 10461-0367 | 2019-01-31 |
| 1336603331 | Joseph A Sanchez | Physician Assistant | 6 Ploughmans Bush, Bronx, NY 10471-3541 | 2019-01-24 |
| 1639651581 | Aaron Sosa | Physician Assistant | Tower 1, 1250 Waters Pl 11th Fl, Bronx, NY 10461 | 2018-09-06 |
| 1275032542 | Ahmed Mahir | Physician Assistant | 32 Westchester Sq, Bronx, NY 10461-3514 | 2018-02-01 |
| 1730601113 | Alexandra Taylor Martin | Physician Assistant | 661 King Avenue, Bronx, NY 10464 | 2017-07-07 |
| Find all providers in BRONX | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.