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SHAWN BELL MATHEWS M.D.
NPI 1043341043
Otolaryngology in Lagrange, GA

Active since March 08, 2007PECOS EnrolledAccepts Medicare Assignment
92.93/100
CMS Quality Rating
300 MEDICAL DR STE 705, LAGRANGE, GA 30240(706) 803-7960 Get Directions Write a Review

NPPES record last updated: April 1, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Apr 1, 2024, Oct 2, 2019, Mar 21, 2018 (3 updates tracked since 2018).

About Shawn Bell Mathews M.d. NPPES

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

SHAWN BELL MATHEWS M.D. (NPI 1043341043) is an individual otolaryngology provider in Lagrange, Georgia, licensed in Georgia (079724) and active in the NPI registry since March 2007. He is enrolled in Medicare PECOS, is affiliated with Wellstar West Georgia Medical Center, and is a graduate of Other (1992).

NPPES Registry Identity

NPI1043341043
Entity TypeIndividualMale
Primary Taxonomy207Y00000X
Provider Legal NameSHAWN BELL MATHEWSCredential: M.D.
Location Address300 MEDICAL DR STE 705Lagrange, GA 30240-4130
Mailing Address300 Medical Dr Ste 705Lagrange, GA 30240-4130 · (706) 803-7960
Phone(706) 803-7960
Sole ProprietorNo
Medical School CMSOtherGraduated 1992
Enumeration DateMarch 8, 2007
Last NPPES UpdateApril 1, 20243 updates tracked since enumeration
NPPES CertifiedApril 1, 2024
✔ NPI 1043341043 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOtolaryngologyAllopathic & Osteopathic Physicians
Taxonomy Code207Y00000X
License✔ Licensed in GA · 079724
Definition
An otolaryngologist-head and neck surgeon provides comprehensive medical and surgical care for patients with diseases and disorders that affect the ears, nose, throat, the respiratory and upper alimentary systems and related structures of the head and neck. An otolaryngologist diagnoses and provides medical and/or surgical therapy or prevention of diseases, allergies, neoplasms, deformities, disorders and/or injuries of the ears, nose, sinuses, throat, respiratory and upper alimentary systems, face, jaws and the other head and neck systems. Head and neck oncology, facial plastic and reconstructive surgery and the treatment of disorders of hearing and voice are fundamental areas of expertise.
300 MEDICAL DR STE 705, Lagrange, GA 30240
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Other Identifiers 2

OtherAZ0728210AZ · Blue Cross Blue Shield
Medicaid755879AZ

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Alliant Health Plans, Inc., Ambetter from Absolute Total Care, Ambetter Health and more.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

Shawn Bell Mathews M.d. 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 ID3779674254
PECOS Enrollment IDI20180802000894
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.

Areas of Expertise CMS Part B claims 6

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
220 services157 patients
New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204
This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.
120 services120 patients
Removal of impacted ear wax 69210
Impacted ear wax removal is a safe procedure to clear blockages in the ear canal caused by hardened ear wax. A healthcare professional uses specialized tools or a gentle irrigation method to loosen and remove the wax, improving hearing and alleviating discomfort.
114 services93 patients
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
99 services91 patients
Diagnostic exam of voice box using a flexible endoscope 31575
This procedure involves a doctor examining your voice box using a flexible endoscope, a thin tube with a light and camera. It's inserted through your nose or mouth to visualize your throat area. It helps detect any abnormalities in your voice box, ensuring optimal vocal health.
70 services66 patients
New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203
This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.
17 services17 patients

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Wellstar West Georgia Medical Center

Acute Care Hospitals · Lagrange, GA
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number110016
Location1514 Vernon RoadLagrange, GA 30240 · Troup County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 30240 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
$124.10 typical visit price
range $53.31 – $164.04
Typical copayment $31.02 (range $13.32 – $41.01)
Most-billed visit code 99204
Established Patient
$66.89 typical visit price
range $16.68 – $133.24
Typical copayment $16.72 (range $4.17 – $33.31)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

92.93/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored through an Alternative Payment Model
Quality80.38
Promoting Interoperability100
Improvement Activities40

Other Providers at the Same Location NPPES 3

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

JENNIFER NICHOLE SPEELMAN FNP-C
Nurse Practitioner (Family)
300 MEDICAL DR STE 705
LAGRANGE, GA 30240
Troup County (706) 803-7960
TOMMY JOHN MORGAN M.D.
Psychiatry & Neurology (Child & Adolescent Psychiatry)
300 MEDICAL DR STE 705
LAGRANGE, GA 30240
Troup County (706) 885-0111
DAWN STONE FNP-C
Nurse Practitioner
300 MEDICAL DR STE 705
LAGRANGE, GA 30240
Troup County (706) 803-7960

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Shawn Mathews's NPI number?

The NPI number for Shawn Mathews is 1043341043. It was assigned to this individual provider in the NPPES registry on March 8, 2007.

Where is Shawn Mathews located?

Shawn Mathews practices at 300 Medical Dr Ste 705, Lagrange, GA 30240. The listed phone number is (706) 803-7960.

What is Shawn Mathews's specialty?

The primary specialty registered for this NPI is Otolaryngology with taxonomy code 207Y00000X.

Is Shawn Mathews enrolled in Medicare?

Yes. Shawn Mathews is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Shawn Mathews accept?

Health plans from Alliant Health Plans, Inc., Ambetter Health, Ambetter from Absolute Total Care, Ambetter of Alabama and Ambetter of North Carolina and 1 other insurer list Shawn Mathews as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Shawn Mathews affiliated with any hospitals?

According to CMS data, Shawn Mathews is affiliated with Wellstar West Georgia Medical Center.

When was this NPI record last updated?

The NPPES record for Shawn Mathews was last updated on April 1, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.