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MARC T. MATHIAS M.D.
NPI 1073774121
Ophthalmology - Retina Specialist in Aurora, CO

Active since June 20, 2008PECOS EnrolledAccepts Medicare Assignment
97.58/100
CMS Quality Rating
12605 E 16TH AVE, AURORA, CO 80045(720) 848-0000 Get Directions Write a Review

NPPES record last updated: April 6, 2017. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Marc T. Mathias M.d. NPPES

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

MARC T. MATHIAS M.D. (NPI 1073774121) is an individual retina specialist in Aurora, Colorado, licensed in Colorado (DR.0051109) and active in the NPI registry since June 2008. He is enrolled in Medicare PECOS and is a graduate of Ohio State University College Of Medicine (2008).

NPPES Registry Identity

NPI1073774121
Entity TypeIndividualMale
Primary Taxonomy207WX0107X
Provider Legal NameMARC T. MATHIASCredential: M.D.
Location Address12605 E 16TH AVEAurora, CO 80045-2545
Mailing AddressPo Box 110429Aurora, CO 80042-0429 · (303) 493-7000
Phone(720) 848-0000
Sole ProprietorNo
Medical School CMSOhio State University College Of MedicineGraduated 2008
Enumeration DateJune 20, 2008
Last NPPES UpdateApril 6, 2017
✔ NPI 1073774121 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyOphthalmology · Retina SpecialistAllopathic & Osteopathic Physicians
Taxonomy Code207WX0107X
License✔ Licensed in CO · DR.0051109
Definition
An ophthalmologist who specializes in the diagnosis and treatment of vitreoretinal diseases.
Also ListedOphthalmologyTaxonomy 207W00000X · License CO-51109 (CO)
12605 E 16TH AVE, Aurora, CO 80045
Open in Google Maps ↗

Other Identifiers 2

Medicare PINCOA107750CO
Medicaid61950076CO

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Medica, UnitedHealthcare.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

Marc T. Mathias 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 ID1557517695
PECOS Enrollment IDI20120806000801
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 12

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.

Imaging of retina 92134
Imaging of the retina is a non-invasive procedure that captures detailed images of your eye's interior. This helps detect conditions like macular degeneration or retinal detachment. It's painless and takes only a few minutes.
1,052 services469 patients
Imaging of retina 92134
Imaging of the retina is a non-invasive procedure that captures detailed images of your eye's interior. This helps detect conditions like macular degeneration or retinal detachment. It's painless and takes only a few minutes.
993 services401 patients
Injection of drug into eye 67028
An injection into the eye is a procedure where a medication is delivered directly into your eye to treat various conditions. A local anesthetic is applied to numb the eye, ensuring minimal discomfort. The drug helps manage diseases like macular degeneration or diabetic retinopathy.
616 services121 patients
Established patient complete exam of visual system 92014
An established patient complete exam of the visual system involves a thorough check of your eyes and vision. It assesses eye health, checks for diseases, and measures your ability to see clearly at different distances. It's a routine, non-invasive procedure.
591 services392 patients
Injection of drug into eye 67028
An injection into the eye is a procedure where a medication is delivered directly into your eye to treat various conditions. A local anesthetic is applied to numb the eye, ensuring minimal discomfort. The drug helps manage diseases like macular degeneration or diabetic retinopathy.
521 services130 patients
Established patient complete exam of visual system 92014
An established patient complete exam of the visual system involves a thorough check of your eyes and vision. It assesses eye health, checks for diseases, and measures your ability to see clearly at different distances. It's a routine, non-invasive procedure.
460 services331 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 80045 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
$132.55 typical visit price
range $58.06 – $174.82
Typical copayment $33.13 (range $14.51 – $43.70)
Most-billed visit code 99204
Established Patient
$72.20 typical visit price
range $18.88 – $142.79
Typical copayment $18.05 (range $4.72 – $35.69)
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.

97.58/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored through an Alternative Payment Model
Quality86.53
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.

KEVIN BRADLEY ROTHCHILD MD
Surgery (Trauma Surgery)
12605 E 16TH AVE
AURORA, CO 80045
Adams County (303) 724-2728
DR. JONATHAN ORSBORN MD
Pediatrics (Pediatric Emergency Medicine)
12605 E 16TH AVE
AURORA, CO 80045
Adams County (720) 848-0000
ERIN SLOUN FIELDS PHARMD
Pharmacist
12605 E 16TH AVE
AURORA, CO 80045
Adams County (720) 848-4083
DR. JUAN PABLO IDROVO M.D.
Surgery (Surgical Critical Care)
12605 E 16TH AVE
AURORA, CO 80045
Adams County (303) 724-8366
STACEY M JOHNSON APRN
Nurse Practitioner (Adult Health)
12605 E 16TH AVE
AURORA, CO 80045
Adams County (720) 848-0000
ANDREA LYNNE HALL CRNA
Nurse Anesthetist, Certified Registered
12605 E 16TH AVE
AURORA, CO 80045
Adams County (720) 848-0000
KRISTI WHARTON SWIM FNP
Nurse Practitioner (Family)
12605 E 16TH AVE
AURORA, CO 80045
Adams County (720) 848-0000
LAURA TIERNEY YOST CRNA
Nurse Anesthetist, Certified Registered
12605 E 16TH AVE
AURORA, CO 80045
Adams County (720) 848-0000

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 Marc Mathias's NPI number?

The NPI number for Marc Mathias is 1073774121. It was assigned to this individual provider in the NPPES registry on June 20, 2008.

Where is Marc Mathias located?

Marc Mathias practices at 12605 E 16th Ave, Aurora, CO 80045. The listed phone number is (720) 848-0000.

What is Marc Mathias's specialty?

The primary specialty registered for this NPI is Ophthalmology, specializing in Retina Specialist, with taxonomy code 207WX0107X.

Is Marc Mathias enrolled in Medicare?

Yes. Marc Mathias 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 Marc Mathias accept?

Health plans from Medica and UnitedHealthcare list Marc Mathias 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.

When was this NPI record last updated?

The NPPES record for Marc Mathias was last updated on April 6, 2017. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 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.