DR. SHISHIR MATHUR M.D. NPI 1003016957

Internal Medicine (Cardiovascular Disease) in Glastonbury, CT

NPI 1003016957 Individual Male Years of Experience 24 Internal Medicine Cardiovascular Disease PECOS Enrolled Accepts Medicare Approved Payment

NPI Profile for DR. SHISHIR MATHUR M.D.

Shishir Mathur is an internal medicine provider established in Glastonbury, Connecticut and his medical specialization is internal medicine (cardiovascular disease) with more than 24 years of experience. The NPI number of Shishir Mathur is 1003016957 and was assigned on July 2007. The practitioner's primary taxonomy code is 207RC0000X with license number 047888 (CT). The provider is registered as an individual and his NPI record was last updated 5 years ago.

An internist like Dr. Shishir Mathur M.d. is a physician who has completed an internal medicine residency and is board-certified or board-eligible in an internist specialty. Internists are trained to care for adults of all ages for many different medical conditions. An internist typically monitors chronic physical conditions, identifies acute diseases, provides family planning, provides counseling about wellness and disease prevention, etc.

Shishir Mathur is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME) and a Home Health Agency (HHA).

Shishir Mathur is registered with Medicare and accepts claims assignment, this means the provider accepts Medicare's approved amount for the cost of rendered services as full payment. Participating providers may not charge Medicare beneficiaries more than Medicare's approved amount for their services. Medicare beneficiaries still have to pay a coinsurance or copayment amount for a visit or service. According to Medicare claims data he has hospital affiliations with Hartford Hospital, The Hospital Of Central Connecticut, St Francis Hospital & Medical Center and Midstate Medical Center.

The typical physician office visit costs for Medicare beneficiaries in this area are: $36.17 for a new patient copayment and $19.77 for an established patient copayment.

NPI

1003016957

Provider NameDR. SHISHIR MATHUR M.D.
Provider Location Address27 SYCAMORE ST STE 400 GLASTONBURY, CT 06033
Provider Mailing Address27 SYCAMORE ST STE 400 GLASTONBURY, CT 06033
GenderMale
NPI Entity TypeIndividual
Medical School NameOTHER
Graduation Year1999
Is Sole Proprietor?No
Is Organization Subpart?N/A
Enumeration Date07-19-2007
Last Update Date07-26-2017


Primary Taxonomy

Taxonomy Code207RC0000X
ClassificationInternal Medicine
TypeAllopathic & Osteopathic Physicians
SpecializationCardiovascular Disease
License No.047888
License StateCT
Taxonomy DescriptionAn 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.

Business Address

DR. SHISHIR MATHUR M.D.
27 SYCAMORE ST STE 400
GLASTONBURY, CT
ZIP 06033
Phone:
Fax: (860) 633-5250

Get Directions


Mailing Address

DR. SHISHIR MATHUR M.D.
27 SYCAMORE ST STE 400
GLASTONBURY, CT
ZIP 06033
Phone:
Fax: (860) 633-5250



PECOS Enrollment and Medicare Participation

What is PECOS?
PECOS is the Medicare Provider, Enrollment, Chain and Ownership System. PECOS is Medicare's enrollment and revalidation system and it is the primary source of information about verified Medicare professionals. A NPI number is necessary to register in PECOS. Providers must enroll in PECOS to avoid denied claims.

Registered in PECOS? Yes
PECOS PAC ID8022156645
PECOS Enrollment IDI20091118000620
Accepts Medicare Assignment? Yes "What does it mean "accepts medicare assignment"?
When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.
Eligible order / refer Part B Clinical Laboratory and ImagingYes
Eligible order / refer Durable Medical EquipmentYes
Eligible order / refer Home Health Agency (HHA)Yes
Eligible order / refer Power Mobility DevicesNo

Physician Office Visit Costs

The provider accepts as payment the Medicare approved amount. Medicare beneficiaries should not be billed for more than the Medicare deductible and coinsurance amounts. Medicare pricing is usually a reference point for private insurance covered patients. The prices below reflect the costs for new and established patients in the 06033 ZIP code area.

New Patients Office Visits Costs *
Most Utilized Procedure Code for new patients office visits: 99204
Minimum New Patient Pricing Maximum New Patient Pricing Typical New Patient Pricing
$63.47 $190.87 $144.69
Minimum New Patient Copayment Maximum New Patient Copayment Typical New Patient Copayment
$15.86 $47.71 $36.17
Established Patients Office Visits Costs *
Most Utilized Procedure Code for established patients office visits: 99213
Minimum Established Patient Pricing Maximum Established Patient Pricing Typical Established Patient Pricing
$20.08 $156.18 $79.11
Minimum Established Patient Copayment Maximum Established Patient Copayment Typical Established Patient Copayment
$5.02 $39.04 $19.77

* The physician office visit costs information is obtained by Medicare's statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.

Hospital Affiliations

Medicare hospital affiliation is identified through self-reporting data, inpatient, outpatient, physician and ancillary service claims linked by the Medicare claims NPI number and place of service code. Additionally, to further determine provider hospital affiliation the clinician must have provided services to at least three patients on three different dates in the last 12 months. Shishir Mathur is affiliated with the following medical facilities:

Hospital Name Address Phone Hospital Type CMS Certification Number (CCN) Overall Rating
HARTFORD HOSPITAL80 SEYMOUR STREET
HARTFORD, CT 6102
(860) 545-5000Acute Care Hospitals70025
THE HOSPITAL OF CENTRAL CONNECTICUT100 GRAND STREET
NEW BRITAIN, CT 6050
(860) 224-5011Acute Care Hospitals70035
ST FRANCIS HOSPITAL & MEDICAL CENTER114 WOODLAND STREET
HARTFORD, CT 6105
(860) 714-4000Acute Care Hospitals70002
MIDSTATE MEDICAL CENTER435 LEWIS AVENUE
MERIDEN, CT 6450
(203) 694-8200Acute Care Hospitals70017

Secondary Taxonomies


The secondary taxonomy codes define the provider type, classification, and specialization. For individual NPIs the license data is associated to each taxonomy code.

No. Taxonomy Code Type Classification Specialization License No. State Primary
1207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology047888CTNo

Taxonomy Description: an area of medicine within the subspecialty of cardiology, which uses specialized imaging and other diagnostic techniques to evaluate blood flow and pressure in the coronary arteries and chambers of the heart and uses technical procedures and medications to treat abnormalities that impair the function of the cardiovascular system.

Additional Identifiers


Additional identifier(s) currently or formerly used as an identifier for the provider. The codes may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State
1003016957MEDICAID (05)CT

NPI Validation Check Digit Calculation


The following table explains step by step the NPI number validation process using the ISO standard Luhn algorithm.

Start with the original NPI number, the last digit is the check digit and is not used in the calculation.
1003016957
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
20030112910
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 0 + 0 + 3 + 0 + 1 + 1 + 2 + 9 + 1 + 0 + 24 = 43
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
50 - 43 = 77

The NPI number 1003016957 is valid because the calculated check digit 7 using the Luhn validation algorithm matches the last digit of the original NPI number.

NPI Footnotes

What is the National Provider Indentifier (NPI)?
The NPI is 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.

Provider Location Address
The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.

Provider Mailing Address
The mailing address of the provider being identified. This address may contain the same information as the provider location address.

Entity Type Code
Dr. Shishir Mathur M.d. is registered as an entity type code: 1. The entity type code describes the type of health care provider that is being assigned an NPI. The entity type codes are:

  • 1 = Person: individual human being who furnishes health care.
  • 2 = Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)

What is a Subpart?
Subparts are the components and separate physical locations of organization health care providers. Subpart examples include:
Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.

Provider Other Organization Name
The other organization name is the alternative last name by which the provider is or has been known (if an individual) or other name by which the organization provider is or has been known. The code identifying the type of other name. The provider other organization name codes are:
1 = former name;
2 = professional name;
3 = doing business as (d/b/ a) name;
4 = former legal business name; :
5 = other.

Provider Enumeration Date
The date the provider was assigned a unique identifier (assigned an NPI).

Last Update Date
The date that a NPI record was last updated or changed.

Primary Taxonomy Code
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Authorized Official Name
The name of the person authorized to submit the NPI application or to officially change data for a health care provider.