MOHIT MATHAVAN MD
NPI 1629770383
Student in an Organized Health Care Education/Training Program in Quincy, IL

Q: What is Mohit Mathavan's NPI number?

The NPI number for Mohit Mathavan is 1629770383. It was assigned to this individual provider in the NPPES registry on March 20, 2023.

Q: What is Mohit Mathavan's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Q: When was this NPI record last updated?

The NPPES record for Mohit Mathavan was last updated on July 13, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 months 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 March 20, 2023PECOS Enrolled

612 N 11TH ST, QUINCY, IL 62301(217) 224-9484(217) 224-7950 Get Directions Write a Review

NPPES record last updated: July 13, 2026. Verified against the NPPES registry weekly; last sync: October 04, 2026.

Record update history: Jul 13, 2026, Mar 20, 2023 (2 updates tracked since 2023).

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About Mohit Mathavan Md NPPES

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

MOHIT MATHAVAN MD (NPI 1629770383) is an individual student in an organized health care education/training program in Quincy, Illinois and active in the NPI registry since March 2023. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1629770383

Entity TypeIndividualMale

Primary Taxonomy390200000X

Provider Legal NameMOHIT MATHAVANCredential: MD

Location Address612 N 11TH STQuincy, IL 62301-2662

Mailing Address612 N 11th StQuincy, IL 62301-2662 · (217) 224-9484 · Fax (217) 224-7950

Phone(217) 224-9484

Fax(217) 224-7950

Sole ProprietorNo

Enumeration DateMarch 20, 2023

Last NPPES UpdateJuly 13, 20262 updates tracked since enumeration

NPPES CertifiedJuly 13, 2026

✔ NPI 1629770383 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care

Taxonomy Code390200000X

Definition

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

Also ListedFamily MedicineTaxonomy 207Q00000X · License 125.089034 (IL)

Also ListedFamily Medicine · Sports MedicineTaxonomy 207QS0010X · License 125.089034 (IL)

612 N 11TH ST, Quincy, IL 62301

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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mohit Mathavan Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

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.

DEANDRA RANGEL

Social Worker