Kallukalam J Mathew (NPI# 1720033392, PAC ID# 8325232010) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is CARDIOVASCULAR DISEASE (CARDIOLOGY).
| Nation Provider ID (NPI) | 1720033392 |
| PAC ID by PECOS | 8325232010 |
| Professional Enrollment ID | I20101026001409 |
| Full Name | Kallukalam J Mathew |
| Organization Legal Name | RIVERSIDE MEDICAL ASSOCIATES PA |
| Address |
4000 Mitchellville Rd Suite 200 Bowie MD 20716-3104 |
| Phone Number | 3012629138 |
| Gender | M |
| Graduation Year | 1959 |
| Primary Specialty | CARDIOVASCULAR DISEASE (CARDIOLOGY) |
| Group Practice PAC ID | 9830086487 |
| Number of Group Practice Members | 5 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 210051 | DOCTORS' COMMUNITY HOSPITAL |
| Address | Phone | Organization |
|---|---|---|
| 4000 Mitchellville Rd, Suite 200, Bowie, MD 20716-3104 | 3012629138 | RIVERSIDE MEDICAL ASSOCIATES PA |
| 6400 Marlboro Pike, District Heights, MD 20747-2841 | 3017367000 | RIVERSIDE MEDICAL ASSOCIATES PA |
| 6504 Kenilworth Ave, Suite 200, Riverdale, MD 20737-1304 | 3019270088 | RIVERSIDE MEDICAL ASSOCIATES PA |
| Organization Legal Name | RIVERSIDE MEDICAL ASSOCIATES PA |
| Physicians | 5 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Mangal Katikineni | Nephrology | Riverside Medical Associates Pa | 6504 Kenilworth Ave, Suite 200, Riverdale, MD 20737-1304 |
| Jane Kapustin | Nurse Practitioner | Riverside Medical Associates Pa | 4000 Mitchellville Rd, Suite 200, Bowie, MD 20716-3104 |
| Madhu M Katikineni | Endocrinology | Riverside Medical Associates Pa | 4000 Mitchellville Rd, Suite 200, Bowie, MD 20716-3104 |
| Lucia Novak | Nurse Practitioner | Riverside Medical Associates Pa | 6502 Kenilworth Ave, Suite 100, Riverdale, MD 20737-1372 |
| Street Address |
4000 MITCHELLVILLE RD SUITE 200 |
| City | BOWIE |
| State | MD |
| Zip | 20716-3104 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Roraine Bunag | Qualified Audiologist | Centers for Advanced Ent Care LLC | 4000 Mitchellville Rd, Suite A414, Bowie, MD 20716-3142 |
| Cary A Peralta | Physical Therapy | Capital Orthopaedic Specialists LLC | 4000 Mitchellville Rd, Suite B116, Bowie, MD 20716-3143 |
| Garrett J Lynch | Orthopedic Surgery | Centers for Advanced Orthopaedics LLC | 4000 Mitchellville Rd, Bowie, MD 20716-3104 |
| Katherine S Perry | Otolaryngology | Centers for Advanced Ent Care LLC | 4000 Mitchellville Rd, Suite A414, Bowie, MD 20716-3142 |
| Louis J Ruland Iii | Orthopedic Surgery | Centers for Advanced Orthopaedics LLC | 4000 Mitchellville Rd, Bowie, MD 20716-3104 |
| Jane Kapustin | Nurse Practitioner | Riverside Medical Associates Pa | 4000 Mitchellville Rd, Suite 200, Bowie, MD 20716-3104 |
| Diane Taber | Chiropractic | Taber Chiropractic, PC | 4000 Mitchellville Rd, Suite A200, Bowie, MD 20716-3103 |
| Theodore William Taber | Chiropractic | Taber Chiropractic, PC | 4000 Mitchellville Rd, Suite A200, Bowie, MD 20716-3103 |
| Marlene L Adore-lewis | Physical Therapy | Capital Orthopaedic Specialists LLC | 4000 Mitchellville Rd, Suite B116, Bowie, MD 20716-3143 |
| Matthew P Ross | Nurse Practitioner | Centers for Advanced Ent Care LLC | 4000 Mitchellville Rd, Suite A414, Bowie, MD 20716-3142 |
| Find all physicians in the same address | |||
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Steven T Kulsar | Qualified Audiologist | Lifestyle Hearing Professionals, LLC | 4000 Mitcheville Rd, B124, Bowie, MD 20716 |
| Leslie Ann Gilbert | Qualified Audiologist | Lifestyle Hearing Professionals, LLC | 4000 Mitcheville Rd, B124, Bowie, MD 20716 |
| Mark E Schutz | Anesthesiology | 15001 Health Ctr Dr, Bowie, MD 20716-1017 | |
| Paul T Lyons | Emergency Medicine | Maryland Emergency Medicine Network Physicians LLC | 15001 Health Ctr Dr, Bowie, MD 20716-1017 |
| Maryann Coyle | Certified Registered Nurse Anesthetist (crna) | Capital Care Anesthesia LLC | 14999 Health Ctr Dr, Suite 103, Bowie, MD 20716-1075 |
| Robert C Jones | Anesthesiology | Capital Care Anesthesia LLC | 14999 Health Ctr Dr, Suite 103, Bowie, MD 20716-1075 |
| Tiffany S Owens | Anesthesiology | Capital Care Anesthesia LLC | 14999 Health Ctr Dr, Suite 103, Bowie, MD 20716-1075 |
| Beth A Schwartz | Ophthalmology | Solomon Eye Physicians and Surgeons, LLC | 14999 Health Ctr Dr, Suite 101, Bowie, MD 20716-1075 |
| Jerome E Mcqueen | Anesthesiology | 14999 Health Ctr Dr, Suite 103, Bowie, MD 20716-1075 | |
| Mukul K Das | Diagnostic Radiology | Community Radiology Associates Inc | 14999 Health Ctr Dr, Suite 102, Bowie, MD 20716-1075 |
| Find all physicians in zip 20716 | |||
| City | BOWIE |
| Zip Code | 20716 |
| Specialty | CARDIOVASCULAR DISEASE (CARDIOLOGY) |
| City + Specialty | BOWIE + CARDIOVASCULAR DISEASE (CARDIOLOGY) |
Please comment or provide details below to improve the information on Kallukalam J Mathew.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.