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Christina Maria Mathai

Hospitalist

Allopathic & Osteopathic Physicians

820 Prudential Dr Ste 304, Credentialing Department, Jacksonville, FL 32207-8205

(904) 346-3649 (904) 202-2092

PECOS Enrollment

This provider is enrolled in PECOS as CHRISTINA MATHAI.

Based on the most recent information from CMS, provider Christina Maria Mathai is legally eligible to order and refer claims for Part B, HHA and DME services only.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records yesterday at 11:21 AM.

Profile Details

Provider ID
1336448976
Provider Type
Individual
Full Name
Mathai, Christina Maria
Title
Dr.
Credential
M.D.

Gender
Female
Sole Proprietor
No
Enumeration Date
3/22/2011
Last Updated
10/10/2024

Contact Information

Practice Location

820 Prudential Dr Ste 304, Credentialing Department, Jacksonville, FL 32207-8205

(904) 346-3649

(904) 348-5627

Mailing Location

PO Box 746638, Atlanta, GA 30374-6638

(904) 202-2092

(904) 376-4075

Provider Taxonomies

Code	Description	License
Code 208M00000X Primary	Description Hospitalist Allopathic & Osteopathic Physicians	License ME119997 Florida
Code 207R00000X	Description Internal Medicine Allopathic & Osteopathic Physicians	License ME119997 Florida

Provider Identifiers

ID	Description	Issuer
ID P01380042	Description Other	Issuer RR MEDICARE Florida
ID 012199700	Description Medicaid	Issuer Unlisted Florida

Christina Maria Mathai

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

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Description

License

Code

Description

License

Code

Description

License

Provider Identifiers

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ID

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ID

Description

Issuer

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Stone-Smith, Abbie Marie