LISA PHILIP MATHEW NP-C
NPI 1043645476
Nurse Practitioner in Fort Worth, TX

Q: What is Lisa Mathew's NPI number?

The NPI number for Lisa Mathew is 1043645476. It was assigned to this individual provider in the NPPES registry on September 4, 2013.

Q: What is Lisa Mathew's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

Q: When was this NPI record last updated?

The NPPES record for Lisa Mathew was last updated on March 25, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since September 04, 2013PECOS EnrolledAccepts Medicare Assignment

1902 WINDSOR PL STE 102, FORT WORTH, TX 76110(682) 207-1700(682) 250-5246 Get Directions Write a Review

NPPES record last updated: March 25, 2021. Verified against the NPPES registry weekly; last sync: August 09, 2026.

On this page

About Lisa Philip Mathew Np-c NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

LISA PHILIP MATHEW NP-C (NPI 1043645476) is an individual nurse practitioner in Fort Worth, Texas, licensed in Texas (AP124548) and active in the NPI registry since September 2013. She is enrolled in Medicare PECOS and is a graduate of Other (2013).

NPPES Registry Identity

NPI1043645476

Entity TypeIndividualFemale

Primary Taxonomy363L00000X

Provider Legal NameLISA PHILIP MATHEWCredential: NP-C

Location Address1902 WINDSOR PL STE 102Fort Worth, TX 76110-1866

Mailing Address1902 Windsor Pl Ste 102Fort Worth, TX 76110-1866 · (682) 207-1700 · Fax (682) 250-5246

Phone(682) 207-1700

Fax(682) 250-5246

Sole ProprietorNo

Medical School CMSOtherGraduated 2013

Enumeration DateSeptember 4, 2013

Last NPPES UpdateMarch 25, 2021

NPPES CertifiedMarch 25, 2021

✔ NPI 1043645476 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363L00000X

License✔ Licensed in TX · AP124548

Definition

(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.

1902 WINDSOR PL STE 102, Fort Worth, TX 76110

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Other Identifiers 1

Medicaid328172704TX

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Texas, Molina Healthcare.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Lisa Philip Mathew Np-c is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID6406915800

PECOS Enrollment IDI20140102000517

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 76110 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$87.20 typical visit price

range $56.47 – $171.07

Typical copayment $21.80 (range $14.11 – $42.76)

Most-billed visit code 99203

Established Patient

$99.68 typical visit price

range $18.18 – $139.68

Typical copayment $24.92 (range $4.54 – $34.92)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

FORTWORTH RENAL GROUP PA

Internal Medicine (Nephrology)