DR. THECKEDATH MATHEW (NPI# 1144264862) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1144264862 |
| Entity Type | Individual |
| Full Name | DR. THECKEDATH MATHEW |
| Credential | M.D. |
| Practice Address |
1445 Portland Avenue Suite 208 Rochester NY 14621 |
| Mailing Address |
21 Runnymede Court Rochester NE 14618 |
| Practice Telephone | 5853382322 |
| Enumeration Date | 2006-06-15 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | X |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
137136 | NY | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NY | 00719080 | 05 |
| Street Address |
1445 PORTLAND AVENUE SUITE 208 |
| City | ROCHESTER |
| State | NY |
| Zip Code | 14621 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407818883 | Peter Helpbringer Van Brunt | Internal Medicine | 1445 Portland Avenue, Suite 302, Rochester, NY 14621 | 2006-04-03 |
| 1003162470 | Sara Nichole Brandel | Physician Assistant | 1445 Portland Avenue, Suite 309, Rochester, NY 14621-3008 | 2012-08-03 |
| 1316244239 | Rachel Gianni | Chiropractor | 1445 Portland Avenue, Suite 309, Rochester, NY 14621-3008 | 2011-02-14 |
| 1306851951 | Jennifer Lynn Mulbury | Psychiatry & Neurology | 1445 Portland Avenue, Suite 309, Rochester, NY 14621-3008 | 2006-07-30 |
| 1972521847 | Marc L Siditsky | Physician Assistant | 1445 Portland Avenue, Ste 309, Rochester, NY 14621-3008 | 2006-07-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619515327 | Patti Humphrey | Occupational Therapist | 1831 Ridge Rd. East, Rochester, NY 14621 | 2019-12-12 |
| 1861956682 | Sonya Thomas | Counselor | Sonya Thomas, 490 East Ridge Road, Rochester, NY 14621 | 2019-01-25 |
| 1811478357 | Laura Iannella | Student in an Organized Health Care Education/Training Program | 1455 East Ridge, Rochester, NY 14621 | 2018-08-23 |
| 1982180345 | Naman Sharma | Student in an Organized Health Care Education/Training Program | Rochester General Hospital, 1425 Portland Avenue, Rochester, NY 14621 | 2018-07-18 |
| 1699213447 | Kara Mcallister | Nurse Practitioner | 370 East Ridge Road, Suite 400, Rochester, NY 14621 | 2017-02-01 |
| 1285082982 | Universal Care Services, LLC | In Home Supportive Care | 64 Delamaine Drive, Rochester, NY 14621 | 2016-06-03 |
| 1700243896 | Kenroy King I | Registered Nurse | 67 Warsaw Street, Rochester, NY 14621 | 2016-01-21 |
| 1154794808 | Shari Venisee | Licensed Practical Nurse | 67 Carthage St, Rochester, NY 14621 | 2015-11-03 |
| 1114349024 | Anthony Michael Plavsity | Registered Nurse | 1450 Clifford Ave, Rochester, NY 14621 | 2014-01-11 |
| 1033541107 | The Community Place of Greater Rochester, Inc | Case Management | 500 Carter Street, Rochester, NY 14621 | 2013-07-31 |
| Find all providers in zip 14621 | ||||
| Taxonomy Code | 207RC0000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Cardiovascular Disease |
| An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2008 [7/1/2008: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, http://www.abim.org/. American Osteopathic Board of Internal Medicine, https://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033619515 | Jrk Medical LLC | Internal Medicine | 2633 Superior Dr Nw Ste 100, Rochester, MN 55901-8395 | 2018-02-20 |
| 1134481427 | Jian Shan | Internal Medicine | 30 Hagen Dr Ste 100, Rochester, NY 14625-2658 | 2012-06-12 |
| 1265722508 | Erica Olson Miller | Internal Medicine | 600 Red Creek Dr Ste 100, Rochester, NY 14623 | 2011-04-07 |
| 1427347509 | Nicholas Mckenzie Venci | Internal Medicine | 140 Canal View Blvd Ste 102, Rochester, NY 14623-2808 | 2011-03-29 |
| 1952690026 | John Michael Nayda | Internal Medicine | Unisersity of Rochester Strong Memorial, Division of Cardiology Box 679a, Rochester, NY 14642-0001 | 2011-03-29 |
| 1114242500 | Michael Vornovitsky | Internal Medicine | 601 Elmwood Ave Box 679a, Rochester, NY 14642-0001 | 2010-03-29 |
| 1629302013 | Marvin Galler | Internal Medicine | 300 Hylan Dr, # 107, Rochester, NY 14623-4216 | 2009-10-01 |
| 1952544652 | Kiran Devaraj | Internal Medicine | 1870 Winton Rd S Ste 1, Rochester, NY 14618-3960 | 2009-04-09 |
| 1326295536 | John Allen Spittell Jr. | Internal Medicine | 614 Memorial Pkwy Sw, Rochester, MN 55902-6349 | 2008-08-20 |
| 1114010865 | Gregory Mark Singer | Internal Medicine | 2664 Ridgeway Ave, Rochester, NY 14626-4209 | 2006-10-02 |
| Find all providers in ROCHESTER | ||||
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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.