DR. ROBERT T. MATHIS M.D. NPI 1013087303
Obstetrics & Gynecology in Lihue, HI

About DR. ROBERT T. MATHIS M.D.

Robert Mathis is a women's health care provider established in Lihue, Hawaii and his medical specialization is Obstetrics & Gynecology with more than 26 years of experience. He graduated from St. Louis College Of Physicians And Surgeons in 1997. The NPI number of Robert Mathis is 1013087303 and was assigned on November 2006. The practitioner's primary taxonomy code is 207V00000X with license number MD-10667 (HI). The provider is registered as an individual and his NPI record was last updated 11 years ago.

NPI
1013087303
Provider NameDR. ROBERT T. MATHIS M.D.
Location Address3-3420 KUHIO HWY SUITE B LIHUE, HI 96766
Location Phone(808) 245-1500
Mailing Address3-3420 KUHIO HWY. SUITE B LIHUE, HI 96766
GenderMale
NPI Entity TypeIndividual
Medical School NameST. LOUIS COLLEGE OF PHYSICIANS AND SURGEONS
Graduation Year1997
Is Sole Proprietor?No
Enumeration Date11-08-2006
Last Update Date08-04-2011

Women's health care providers like Dr. Robert T. Mathis M.d. treat and diagnose diseases and conditions that affect a woman's physical and emotional health. Women's health professionals come from a variety of different specialties, including obstetrician/gynecologists, general surgeons, perinatologists, physician assistants, nurse practitioners or nurse midwives. A women's health provider might help you with family planning, breast care, pregnancy and child birth, osteoporosis, menopause, heart disease, etc.Robert Mathis 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), a Home Health Agency (HHA) and Power Mobility Devices.

Robert Mathis 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.

The provider participated in Medicare's Quality Payment Program under the Merit-based Incentive Payment System (MIPS) and has an overall final score of 91.1, based on four performance areas: quality, improvement activities, promoting interoperability, and cost. The purpose of this information is to help people with Medicare make informed decisions and incentivize doctors and clinicians to maximize performance.

The typical physician office visit costs for Medicare beneficiaries in this area are: $35.68 for a new patient copayment and $19.6 for an established patient copayment.



Primary Taxonomy

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.

Taxonomy Code207V00000X
ClassificationObstetrics & Gynecology
TypeAllopathic & Osteopathic Physicians
License No.MD-10667
License StateHI
Taxonomy DescriptionAn obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women.

Accepted Insurance

The NPI profile data indicates this provider might be enrolled and accepting insurance plans from the following companies or healthcare programs:

  • Medicaid
  • Medicare

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Business Address

DR. ROBERT T. MATHIS M.D.
3-3420 KUHIO HWY
SUITE B
LIHUE, HI
ZIP 96766
Phone: (808) 245-1500
Fax: (808) 246-1364

Get Directions


Mailing Address

DR. ROBERT T. MATHIS M.D.
3-3420 KUHIO HWY.
SUITE B
LIHUE, HI
ZIP 96766
Phone: (808) 245-1500
Fax: (808) 246-1364


Location Map

PECOS Enrollment and Medicare Participation Status

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 ID5193747053
PECOS Enrollment IDI20051220000965
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 DevicesYes

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 96766 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
$63.01 $188.11 $142.72
Minimum New Patient Copayment Maximum New Patient Copayment Typical New Patient Copayment
$15.75 $47.02 $35.68
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
$20.25 $154.36 $78.41
Minimum Established Patient Copayment Maximum Established Patient Copayment Typical Established Patient Copayment
$5.06 $38.59 $19.6

* 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.

Overall MIPS Quality Performance

The Merit-based Incentive Payment System (MIPS) is a way providers could use to participate in Medicare's Quality Payment Program (QPP). The MIPS program affects clinician reimbursement for Part B covered professional services and also rewards them for improving the quality of patient care and outcomes.

MIPS Measure Score Weight Score
Quality 40% 100
The Quality category assesses providers performance on clinical practices and patient outcomes under the traditional MIPS program. The quality measures help identify the quality of healthcare processes, outcomes, and patient experiences. The Quality measure category compromises 40% providers final MPIS scores.

There are six collection types for MIPS quality measures: Electronic Clinical Quality Measures (eCQMs), MIPS Clinical Quality Measures (CQMs), Qualified Clinical Data Registry (QCDR) Measures, Medicare Part B claims measures, CMS Web Interface measures and The Consumer Assessment of Healthcare Providers and Systems (CAHPS) for MIPS Survey.
Promoting Interoperability (PI) 25% 69
The Interoperability category measures the providers ability to use technology to exchange and make use of healthcare information in a way that is less burdensome and improves outcomes. The Interoperability measure category compromises 25% providers final MPIS scores.

The MIPS Interoperability measure focuses on the use of certified electronic health record technology (CEHRT) to improve patient access health information, the exchange of information between clinicians and pharmacies and the systematic collection, analysis, and interpretation of healthcare data.
Improvement Activities 15% 40
The Improvement Activities performance category evaluates the providers participation in clinical activities that support the improvement of clinical practice, care delivery, and outcomes. Providers have the option to choose 2 to 4 activities from an inventory of over 100 improvement activities. Providers typically choose the activities that best fit their needs.

The Improvement measures aim to better patient engagement, patient safety and other areas of patient care. The Improvement Activities category compromises 15% of providers final MPIS scores.
Cost 20% 82.1
The Cost performance category asses the amount and types of services provided and how clinicians coordinate care and seek improvement of health outcomes by ensuring patients receive the appropriate services.

Although providers don't determine the price of healthcare services they are important in delivering high-quality care at a reasonable cost. The Cost measures category compromises 20% of providers final MPIS scores.
MIPS Final Score - 91.1
The MIPS program evaluates providers across multiple categories with a specific weight for each category resulting a in a MIPS final score that ranges from 0 to 100 points. The MIPS Final Score determines whether providers receive a negative, neutral or positive MIPS payment adjustment.

Clinician Utilization

The following Healthcare Common Procedure Coding System (HCPCS) codes were publicly reported as the top services rendered by this provider under the Medicare program for the year 2017. The reported codes are based on the top 5 codes for each available Medicare specialty, excluding evaluation and management codes.

  • 11Cervical or vaginal cancer screening; pelvic and clinical breast examination (HCPCS:G0101)

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 Identifier Issuer
285356OTHER (01)HIUHA
101134MEDICARE PIN (08)HI
0000256610OTHER (01)HIHMSA
I47069MEDICARE UPIN (02)HI
575350 01MEDICAID (05)HI

NPI Validation Check Digit Calculation


The following table explains the step by step 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.
1013087303
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
2023081430
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 0 + 2 + 3 + 0 + 8 + 1 + 4 + 3 + 0 + 24 = 47
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
50 - 47 = 33

The NPI number 1013087303 is valid because the calculated check digit 3 using the Luhn validation algorithm matches the last digit of the original NPI number.

Other Providers at the Same Location


The following 20 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1679569586 JAY MICHAEL MURPHY M.D.
Individual
Otolaryngology3-3420 KUHIO HWY SUITE B
LIHUE, HI 96766
(808) 245-1529
1265471668MS. NICOLE SIEVERS RD
Individual
Dietitian, Registered3-3420 KUHIO HWY FOOD & NUTRITION SERVICES
LIHUE, HI 96766
(808) 245-1166
1841229135DR. RAANAN ELAN POKROY M.D.
Individual
Emergency Medicine3-3420 KUHIO HWY
LIHUE, HI 96766
(904) 343-9944
1194750539DR. AMY BETH CORLISS M.D.
Individual
Hospitalist3-3420 KUHIO HWY SUITE B
LIHUE, HI 96766
(808) 245-1100
1255356564DR. RICHARD ANDRE GOSSELIN M.D.
Individual
Orthopaedic Surgery3-3420 KUHIO HWY SUITE B
LIHUE, HI 96766
(808) 245-1500
1477570190DR. FLOYD HOMER POHLMAN M.D.
Individual
Orthopaedic Surgery3-3420 KUHIO HWY SUITE B
LIHUE, HI 96766
(808) 245-1523
1891803391DR. ROBERT D. WOTRING II M.D.
Individual
Pediatrics3-3420 KUHIO HWY SUITE B
LIHUE, HI 96766
(808) 245-1561
1073616561DR. DAVID ROBERT MCDONALD MD
Individual
Obstetrics & Gynecology3-3420 KUHIO HWY
LIHUE, HI 96766
(808) 245-1511
1134224686DR. ALLEN CAMPBELL JOHNSON M.D.
Individual
Radiology (Diagnostic Radiology)3-3420 KUHIO HWY SUITE B
LIHUE, HI 96766
(808) 245-1295
1972608453DR. TYLER A. CHIHARA D.P.M.
Individual
Podiatrist3-3420 KUHIO HWY SUITE B
LIHUE, HI 96766
(808) 245-1523
1245335678DR. ARNULFO B. DIAZ M.D.
Individual
Internal Medicine3-3420 KUHIO HWY SUITE B
LIHUE, HI 96766
(808) 245-1546
1164527537DR. WILLIAM MONTAGUE DOWNS M.D.
Individual
Emergency Medicine3-3420 KUHIO HWY SUITE B
LIHUE, HI 96766
(808) 245-1500
1992800403DR. BRIDGET COLLINS M.D.
Individual
Family Medicine3-3420 KUHIO HWY SUITE B
LIHUE, HI 96766
(808) 245-1532
1013012533DR. ROBERT J. CONRAD M.D.
Individual
Emergency Medicine3-3420 KUHIO HWY SUITE B
LIHUE, HI 96766
(808) 245-1500
1851496012DR. CHRISTOPHER A. JORDAN M.D.
Individual
Surgery3-3420 KUHIO HWY SUITE B
LIHUE, HI 96766
(808) 245-1505
1528163847DR. CHRISTOPHER DAVID ELLIOTT M.D.
Individual
Emergency Medicine3-3420 KUHIO HWY SUITE B
LIHUE, HI 96766
(808) 245-1010
1710082912DR. JOHN T. FUNAI M.D.
Individual
Internal Medicine (Cardiovascular Disease)3-3420 KUHIO HWY SUITE B
LIHUE, HI 96766
(808) 245-1548
1053416586DR. JOHN JAMES CULLINEY M.D.
Individual
Radiology (Diagnostic Radiology)3-3420 KUHIO HWY SUITE B
LIHUE, HI 96766
(808) 245-1293
1417052838DR. MICHAEL I. DIAMANT M.D.
Individual
Anesthesiology3-3420 KUHIO HWY SUITE B
LIHUE, HI 96766
(808) 973-7320
1871698688DR. SURENDRA D. RAO M.D.
Individual
Psychiatry & Neurology (Neurology)3-3420 KUHIO HWY SUITE B
LIHUE, HI 96766
(808) 246-1687

Frequently Asked Questions

What is Dr. Robert Mathis M.D. NPI number?

The NPI number assigned to Dr. Robert Mathis M.D. is 1013087303, registered as an "individual" on November 08, 2006

Where is Dr. Robert Mathis M.D. located?

The provider is located at 3-3420 Kuhio Hwy Suite B Lihue, Hi 96766 and the phone number is (808) 245-1500

Which is Dr. Robert Mathis M.D. specialty?

The provider's speciality is Obstetrics & Gynecology

How many years of experience does Dr. Robert Mathis M.D. have?

The provider has more than 26 years of experience. He graduated from St. Louis College Of Physicians And Surgeons in 1997.

What insurance does Dr. Robert Mathis M.D. accept?

The provider might be accepting Medicaid and Medicare. Please consult your insurance carrier or call the provider to make sure your insurance plan is currently accepted.

Is Dr. Robert Mathis M.D. registered in PECOS?

Yes, as of November 14, 2022 the provider is registered in PECOS and is eligible to order health care services or supplies for Medicare patients. If you are a Medicare beneficiary the provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.

How much is a visit to Dr. Robert Mathis M.D.?

Medicare beneficiaries should expect a typical cost of $142.72 with an average copayment of $35.68 for new patient appointments. Established patients should expect a typical charge of $78.41 and an average copayment of 19.6. Please review your insurance plan or contact the provider directly to determine your specific costs.

What are some of the services provided by Dr. Robert Mathis M.D.?

The most common procedures or services performed by this practitioner are: Cervical or vaginal cancer screening; pelvic and clinical breast examination.

How do I update my NPI information?

The NPI record of Dr. Robert Mathis M.D. was last updated on November 08, 2006. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected]
NPI Profile data is regularly updated with the latest NPI registry information, if you would like to update or remove your NPI Profile in this website please contact us at: [email protected]