MEDICARE: THOMAS P MATHEW FNP-C, PMHNP-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	306380	AZ
2	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	306380	AZ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1770297566
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	THOMAS P MATHEW FNP-C, PMHNP-C

Provider Business Mailing Address
First Line	:	261 N ROOSEVELT AVE
Second Line	:
City	:	CHANDLER
State	:	AZ
Zip	:	85226-2617
Country	:	US
Telephone Number	:	480-677-8282
Fax Number	:	480-535-0962

Provider Business Practice Location Address
First Line	:	8495 S POWER RD STE 103
Second Line	:
City	:	QUEEN CREEK
State	:	AZ
Zip	:	85142-6068
Country	:	US
Telephone Number	:	480-677-8282
Fax Number	:	480-535-0962

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/06/2023
Last Update Date	:	05/28/2026

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Directions to “ THOMAS P MATHEW FNP-C, PMHNP-C” Practice Location

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