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MATTHEW ADAM NIEMI M.D.
NPI 1053548321
Internal Medicine - Nephrology in Worcester, MA

Active since June 15, 2009PECOS EnrolledAccepts Medicare Assignment
97.02/100
CMS Quality Rating
55 LAKE AVE N, DEPARTMENT OF NEPHROLOGY, WORCESTER, MA 01655(508) 856-3155 Get Directions Write a Review

NPPES record last updated: October 27, 2020. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Matthew Adam Niemi M.d. NPPES

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

MATTHEW ADAM NIEMI M.D. (NPI 1053548321) is an individual nephrology provider in Worcester, Massachusetts, licensed in Massachusetts (251074) and active in the NPI registry since June 2009. He is enrolled in Medicare PECOS, is affiliated with Umass Memorial Healthcare-marlborough Hospital, and maintains a secondary practice location in Marlborough.

NPPES Registry Identity

NPI1053548321
Entity TypeIndividualMale
Primary Taxonomy207RN0300X
Provider Legal NameMATTHEW ADAM NIEMICredential: M.D.
Location Address55 LAKE AVE N, DEPARTMENT OF NEPHROLOGYWorcester, MA 01655-0002
Mailing AddressPo Box 415348Boston, MA 02241-5348
Phone(508) 856-3155
Sole ProprietorNo
Medical School CMSTufts University School Of MedicineGraduated 2009
Enumeration DateJune 15, 2009
Last NPPES UpdateOctober 27, 2020
NPPES CertifiedOctober 27, 2020
✔ NPI 1053548321 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · NephrologyAllopathic & Osteopathic Physicians
Taxonomy Code207RN0300X
License✔ Licensed in MA · 251074
Definition
An internist who treats disorders of the kidney, high blood pressure, fluid and mineral balance and dialysis of body wastes when the kidneys do not function. This specialist consults with surgeons about kidney transplantation.
55 LAKE AVE N, Worcester, MA 01655
Open in Google Maps ↗

Secondary Practice Location 1

Location 1157 Union StMarlborough, MA 01752-1228 · Phone (508) 856-3155 · Fax (508) 856-3111

Other Identifiers 1

Medicaid110100066AMA

Accepted Insurance

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

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Matthew Adam Niemi 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 ID8325276157
PECOS Enrollment IDI20140124000336
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.

Medicare Billing Reassignments

2

Medicare enrollment records show Matthew Niemi reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Umass Memorial Medical Group Inc
Same address
Internal Medicine
55 LAKE AVE N
Worcester, MA 01655
  • Reassigned Medicare billing, Massachusetts enrollment
  • 2,902 clinicians in this Medicare group
NPI 1760445373 (508) 334-1000
President & Fellows Of Harvard College
34 mi
Multi-Specialty
75 MOUNT AUBURN ST
Cambridge, MA 02138
  • Reassigned Medicare billing, Massachusetts enrollment
  • 170 clinicians in this Medicare group
NPI 1952366312 (617) 496-9506

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 11

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.
236 services158 patients
Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232
Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.
149 services84 patients
Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes 99233
Follow-up hospital inpatient care per day typically involves a 35-minute check-up by your healthcare provider. This service includes monitoring your health progress, adjusting your treatment plan if needed, and answering any questions you may have about your condition or care.
102 services46 patients
Dialysis services, 4 or more physician visits per month (20 years or older) 90960
Dialysis is a treatment that filters and purifies your blood using a machine. It helps keep your fluids and electrolytes in balance when the kidneys can't do their job. This service includes 4 or more visits per month with a physician to monitor your health and adjust your treatment as needed.
67 services23 patients
Dialysis services, 2-3 physician visits per month (20 years or older) 90961
Dialysis is a treatment that performs the function of healthy kidneys if they're not working properly. It removes waste and excess fluid from your blood. 2-3 physician visits per month are recommended for monitoring your health and adjusting your treatment as needed. This service is available for those aged 20 years and older.
56 services24 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.
37 services37 patients

Hospital Affiliations CMS Care Compare 3

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

Umass Memorial Healthcare-Marlborough Hospital

Acute Care Hospitals · Marlborough, MA
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number220049
Location157 Union StreetMarlborough, MA 01752 · Middlesex County
Emergency services

Milford Regional Medical Center

Acute Care Hospitals · Milford, MA
4/5 CMS rating
OwnershipVoluntary non-profit - Other
CMS Certification Number220090
Location14 Prospect StreetMilford, MA 01757 · Worcester County
Emergency services Birthing friendly

Umass Memorial Medical Center/University Campus

Acute Care Hospitals · Worcester, MA
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number220163
Location55 Lake Avenue NorthWorcester, MA 01655 · Worcester County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 01655 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
$134.47 typical visit price
range $58.86 – $177.36
Typical copayment $33.61 (range $14.71 – $44.34)
Most-billed visit code 99204
Established Patient
$103.48 typical visit price
range $19.11 – $144.84
Typical copayment $25.87 (range $4.77 – $36.21)
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.

97.02/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored through an Alternative Payment Model
Quality78.09
Promoting Interoperability100
Improvement Activities40

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.

HILLARY R. IRONS MD
Emergency Medicine
55 LAKE AVE N
WORCESTER, MA 01655
Worcester County (508) 421-1400
MS. EILEEN A. DUHAMEL NP
Nurse Practitioner
55 LAKE AVE N, DEPARTMENT OF RADIOLOGY
WORCESTER, MA 01655
Worcester County (508) 334-2710
EWA HRYNISZYN CRNA
Nurse Anesthetist, Certified Registered
55 LAKE AVE N, DEPARTMENT OF ANESTHESIOLOGY
WORCESTER, MA 01655
Worcester County (508) 334-3271
HELEN COPSEY PA-C
Physician Assistant
55 LAKE AVE N
WORCESTER, MA 01655
Worcester County (508) 334-8585
DR. ADEPEJU GBADEBO CHAMPION M.D.
Internal Medicine
55 LAKE AVE N
WORCESTER, MA 01655
Worcester County (508) 334-2731
SOWMYA KORAPATI
Internal Medicine (Hematology & Oncology)
55 LAKE AVE N
WORCESTER, MA 01655
Worcester County (508) 334-3550
LAYLA FAKHRZADEH M.D.
Anesthesiology
55 LAKE AVE N, ANESTHESIOLOGY
WORCESTER, MA 01655
Worcester County (508) 334-3271
YOONYIE CHO M.D.
Anesthesiology
55 LAKE AVE N
WORCESTER, MA 01655
Worcester County (508) 334-1000

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 Matthew Niemi's NPI number?

The NPI number for Matthew Niemi is 1053548321. It was assigned to this individual provider in the NPPES registry on June 15, 2009.

Where is Matthew Niemi located?

Matthew Niemi practices at 55 Lake Ave N Department Of Nephrology, Worcester, MA 01655. The listed phone number is (508) 856-3155.

What is Matthew Niemi's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Nephrology, with taxonomy code 207RN0300X.

Is Matthew Niemi enrolled in Medicare?

Yes. Matthew Niemi 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.

Which organizations bill Medicare for Matthew Niemi's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Matthew Niemi reassigns Medicare benefits to 2 organizations: Umass Memorial Medical Group Inc (Worcester, MA) and President & Fellows Of Harvard College (Cambridge, MA). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Matthew Niemi's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Matthew Niemi accept?

Health plans from Anthem Blue Cross and Blue Shield and Blue Cross and Blue Shield of Texas list Matthew Niemi 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 Matthew Niemi affiliated with any hospitals?

According to CMS data, Matthew Niemi is affiliated with Umass Memorial Healthcare-Marlborough Hospital, Milford Regional Medical Center and Umass Memorial Medical Center/University Campus.

When was this NPI record last updated?

The NPPES record for Matthew Niemi was last updated on October 27, 2020. 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.