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KERRICK MARIE MATHIS
NPI 1053084319
Nurse Practitioner in Fort Wayne, IN

Active since July 31, 2021PECOS EnrolledAccepts Medicare Assignment
81.23/100
CMS Quality Rating
11055 TWIN CREEKS CV, FORT WAYNE, IN 46845(260) 425-6120(260) 425-6115 Get Directions Write a Review

NPPES record last updated: December 2, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Dec 2, 2024, Oct 3, 2024, Oct 17, 2022 and 2 more (5 updates tracked since 2021).

About Kerrick Marie Mathis NPPES

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

KERRICK MARIE MATHIS (NPI 1053084319) is an individual nurse practitioner in Fort Wayne, Indiana, licensed in Indiana (71011565A) and active in the NPI registry since July 2021. She is enrolled in Medicare PECOS, is affiliated with Parkview Regional Medical Center, and is a graduate of Other (2021).

NPPES Registry Identity

NPI1053084319
Entity TypeIndividualFemale
Primary Taxonomy363L00000X
Provider Legal NameKERRICK MARIE MATHIS
Location Address11055 TWIN CREEKS CVFort Wayne, IN 46845-2204
Mailing Address11109 Parkview Plaza Dr # 117Fort Wayne, IN 46845-1701
Phone(260) 425-6120
Fax(260) 425-6115
Sole ProprietorNo
Medical School CMSOtherGraduated 2021
Enumeration DateJuly 31, 2021
Last NPPES UpdateDecember 2, 20245 updates tracked since enumeration
NPPES CertifiedDecember 2, 2024
✔ NPI 1053084319 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 IN · 71011565A
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.
11055 TWIN CREEKS CV, Fort Wayne, IN 46845
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, CareSource.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

Kerrick Marie Mathis 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 ID3971900242
PECOS Enrollment IDI20210929001977
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

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.
15 services15 patients

Hospital Affiliations CMS Care Compare 2

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

Parkview Regional Medical Center

Acute Care Hospitals · Fort Wayne, IN
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number150021
Location11109 Parkview Plaza DriveFort Wayne, IN 46845 · Allen County
Emergency services Birthing friendly

Parkview Dekalb Hospital

Acute Care Hospitals · Auburn, IN
OwnershipVoluntary non-profit - Private
CMS Certification Number150045
Location1316 E Seventh StAuburn, IN 46706 · De Kalb County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 46845 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
$82.04 typical visit price
range $53.07 – $161.76
Typical copayment $20.51 (range $13.26 – $40.44)
Most-billed visit code 99203
Established Patient
$94.22 typical visit price
range $16.93 – $132.22
Typical copayment $23.55 (range $4.23 – $33.05)
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.

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.

81.23/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality68.95
Promoting Interoperability100
Improvement Activities40
Cost68.49

Other Providers at the Same Location NPPES 18

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

CHARLES A JONES
Nurse Practitioner
11055 TWIN CREEKS CV
FORT WAYNE, IN 46845
Allen County (260) 425-6120
ANNA SYLVESTER RD, LD
Dietitian, Registered
11055 TWIN CREEKS CV
FORT WAYNE, IN 46845
Allen County (260) 425-6120
SARAH B SCHLIE DO
Family Medicine
11055 TWIN CREEKS CV
FORT WAYNE, IN 46845
Allen County (260) 425-6120
MEGAN C. LEMON MD
Family Medicine
11055 TWIN CREEKS CV
FORT WAYNE, IN 46845
Allen County (260) 425-6120
JANEL D GAGNON MD
Family Medicine
11055 TWIN CREEKS CV
FORT WAYNE, IN 46845
Allen County (260) 425-6120
KATHY L WEHRLE R.D.
Dietitian, Registered
11055 TWIN CREEKS CV
FORT WAYNE, IN 46845
Allen County (260) 425-6120
DR. CHRISTOPHER J CONRAD MD
Family Medicine
11055 TWIN CREEKS CV
FORT WAYNE, IN 46845
Allen County (260) 425-6120
DR. BARBARA E SAGOE M.D
Pediatrics
11055 TWIN CREEKS CV
FORT WAYNE, IN 46845
Allen County (260) 425-6120

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 Kerrick Mathis's NPI number?

The NPI number for Kerrick Mathis is 1053084319. It was assigned to this individual provider in the NPPES registry on July 31, 2021.

Where is Kerrick Mathis located?

Kerrick Mathis practices at 11055 Twin Creeks Cv, Fort Wayne, IN 46845. The listed phone number is (260) 425-6120.

What is Kerrick Mathis's specialty?

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

Is Kerrick Mathis enrolled in Medicare?

Yes. Kerrick Mathis 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 Kerrick Mathis accept?

Health plans from Anthem Blue Cross and Blue Shield and CareSource list Kerrick Mathis 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 Kerrick Mathis affiliated with any hospitals?

According to CMS data, Kerrick Mathis is affiliated with Parkview Regional Medical Center and Parkview Dekalb Hospital.

When was this NPI record last updated?

The NPPES record for Kerrick Mathis was last updated on December 2, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 20 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.