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DR. WILMER NEPTALI MATA M.D.
NPI 1104168509
Surgery in Miami, FL

Active since March 23, 2013PECOS EnrolledAccepts Medicare Assignment
99.93/100
CMS Quality Rating
15955 SW 96TH ST STE 102, MIAMI, FL 33196(786) 467-3435(786) 533-9383 Get Directions Write a Review

NPPES record last updated: July 11, 2019. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Dr. Wilmer Neptali Mata M.d. NPPES

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

DR. WILMER NEPTALI MATA M.D. (NPI 1104168509) is an individual surgery provider in Miami, Florida, licensed in Florida (ME134812) and active in the NPI registry since March 2013. He is enrolled in Medicare PECOS, is affiliated with Baptist Hospital Of Miami, and maintains a secondary practice location in Indianapolis.

NPPES Registry Identity

NPI1104168509
Entity TypeIndividualMale
Primary Taxonomy208600000X
Provider Legal NameDR. WILMER NEPTALI MATACredential: M.D.
Location Address15955 SW 96TH ST STE 102Miami, FL 33196
Mailing AddressPo Box 198054Atlanta, GA 30384-8054
Phone(786) 467-3435
Fax(786) 533-9383
Sole ProprietorYes
Medical School CMSOtherGraduated 2008
Enumeration DateMarch 23, 2013
Last NPPES UpdateJuly 11, 2019
✔ NPI 1104168509 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySurgeryAllopathic & Osteopathic Physicians
Taxonomy Code208600000X
License✔ Licensed in FL · ME134812
Definition
A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery.
15955 SW 96TH ST STE 102, Miami, FL 33196
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Secondary Practice Location 1

Location 12001 W 86th StIndianapolis, IN 46260-1902 · Phone (317) 338-2281

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Florida Blue (BlueCross BlueShield FL), Florida Blue HMO (a BlueCross BlueShield FL company), Oscar Health Maintenance Organization of Florida.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

Dr. Wilmer Neptali Mata 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 ID5698066298
PECOS Enrollment IDI20190808002570
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 3

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.

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.
63 services55 patients
Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes 99222
Initial hospital inpatient care is a service where a healthcare provider spends about 50 minutes per day overseeing your care while you're admitted in the hospital. This includes reviewing your health status, planning your treatment, and ensuring your safety and comfort.
40 services40 patients
Subsequent hospital care with straightforward or low level of medical decision making, per day, if using time, at least 25 minutes 99231
Follow-up hospital inpatient care is a daily service where a healthcare professional checks on your health progress during your hospital stay. Each session typically lasts 15 minutes, involving updates on your condition and adjustments to your treatment plan, if necessary.
25 services24 patients

Hospital Affiliations CMS Care Compare 3

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

Baptist Hospital Of Miami

Acute Care Hospitals · Miami, FL
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number100008
Location8900 N Kendall DrMiami, FL 33176 · Miami-Dade County
Emergency services Birthing friendly

South Miami Hospital

Acute Care Hospitals · South Miami, FL
5/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number100154
Location6200 SW 73rd StSouth Miami, FL 33143 · Miami-Dade County
Emergency services Birthing friendly

West Kendall Baptist Hospital

Acute Care Hospitals · Miami, FL
5/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number100314
Location9555 SW 162 AveMiami, FL 33196 · Miami-Dade County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 33196 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
$96.13 typical visit price
range $60.92 – $187.05
Typical copayment $24.03 (range $15.23 – $46.76)
Most-billed visit code 99203
Established Patient
$75.86 typical visit price
range $18.99 – $150.24
Typical copayment $18.96 (range $4.74 – $37.56)
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.

99.93/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored through an Alternative Payment Model
Quality84.3
Promoting Interoperability100
Improvement Activities40

Other Providers at the Same Location NPPES 8

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

CARLOS A MORAN MARTINEZ
Nurse Practitioner
15955 SW 96TH ST STE 102
MIAMI, FL 33196
Miami-Dade County (305) 271-9777
DR. KAITLIN ELSBETH ROSS MD
Family Medicine
15955 SW 96TH ST STE 102
MIAMI, FL 33196
Miami-Dade County (786) 467-2633
EMILY DAVIDE
Physician Assistant
15955 SW 96TH ST STE 102
MIAMI, FL 33196
Miami-Dade County (305) 271-9777
BAPTIST HEALTH MEDICAL GROUP PHYSICIANS, LLC
Internal Medicine
15955 SW 96TH ST STE 102
MIAMI, FL 33196
Miami-Dade County (786) 595-8080
CHARLY ESCOBAR APRN
Nurse Practitioner
15955 SW 96TH ST STE 102
MIAMI, FL 33196
Miami-Dade County (305) 271-9777
RUPA SEETHARAMAIAH MD
Surgery
15955 SW 96TH ST STE 102
MIAMI, FL 33196
Miami-Dade County (305) 271-9777
DR. MICHAEL R GONZALEZ RAMOS M.D.
Surgery
15955 SW 96TH ST STE 102
MIAMI, FL 33196
Miami-Dade County (305) 271-9777
JESSICA ERIN MILLER APRN
Nurse Practitioner
15955 SW 96TH ST STE 102
MIAMI, FL 33196
Miami-Dade County (305) 271-9777

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 Wilmer Mata's NPI number?

The NPI number for Wilmer Mata is 1104168509. It was assigned to this individual provider in the NPPES registry on March 23, 2013.

Where is Wilmer Mata located?

Wilmer Mata practices at 15955 SW 96th St Ste 102, Miami, FL 33196. The listed phone number is (786) 467-3435.

What is Wilmer Mata's specialty?

The primary specialty registered for this NPI is Surgery with taxonomy code 208600000X.

Is Wilmer Mata enrolled in Medicare?

Yes. Wilmer Mata 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 Wilmer Mata accept?

Health plans from Florida Blue (BlueCross BlueShield FL), Florida Blue HMO (a BlueCross BlueShield FL company) and Oscar Health Maintenance Organization of Florida list Wilmer Mata 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 Wilmer Mata affiliated with any hospitals?

According to CMS data, Wilmer Mata is affiliated with Baptist Hospital Of Miami, South Miami Hospital and West Kendall Baptist Hospital.

When was this NPI record last updated?

The NPPES record for Wilmer Mata was last updated on July 11, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.