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CAROL M MATHEW M.D.
NPI 1104265438
Internal Medicine - Hematology & Oncology in Gainesville, FL

Active since June 20, 2013PECOS EnrolledAccepts Medicare Assignment
78.18/100
CMS Quality Rating
1600 SW ARCHER RD, GAINESVILLE, FL 32610(352) 265-0301(508) 334-6490 Get Directions Write a Review

NPPES record last updated: September 4, 2020. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Sep 4, 2020, Nov 1, 2016 (2 updates tracked since 2016).

About Carol M Mathew M.d. NPPES

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

CAROL M MATHEW M.D. (NPI 1104265438) is an individual hematology & oncology provider in Gainesville, Florida, licensed in Florida (ME146143) and active in the NPI registry since June 2013. She is enrolled in Medicare PECOS, is affiliated with Uf Health Shands Hospital, and is a graduate of Other (2013).

NPPES Registry Identity

NPI1104265438
Entity TypeIndividualFemale
Primary Taxonomy207RH0003X
Provider Legal NameCAROL M MATHEWCredential: M.D.
Location Address1600 SW ARCHER RDGainesville, FL 32610-2903
Mailing AddressPo Box 100276Gainesville, FL 32610-0276 · (352) 265-7996 · Fax (352) 265-7996
Phone(352) 265-0301
Fax(508) 334-6490
Sole ProprietorNo
Medical School CMSOtherGraduated 2013
Enumeration DateJune 20, 2013
Last NPPES UpdateSeptember 4, 20202 updates tracked since enumeration
NPPES CertifiedSeptember 4, 2020
✔ NPI 1104265438 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyInternal Medicine · Hematology & OncologyAllopathic & Osteopathic Physicians
Taxonomy Code207RH0003X
License✔ Licensed in FL · ME146143
Definition
An internist doctor of osteopathy that specializes in the treatment of the combination of hematology and oncology disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine WAS able to obtain a Certificate of Special Qualifications in the field of Hematology and Oncology. The Certificate is NO longer offered.
Also ListedInternal MedicineTaxonomy 207R00000X · License 269221 (MA)
1600 SW ARCHER RD, Gainesville, FL 32610
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Other Identifiers 1

Medicaid107538800FL

Accepted Insurance

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

Carol M Mathew 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 ID7113159427
PECOS Enrollment IDI20200807001098
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 9

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.
317 services247 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.
77 services71 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.
62 services62 patients
Insertion of needle into vein for collection of blood sample 36415
This procedure involves inserting a small needle into a vein, typically in your arm, to collect a blood sample. It's a quick and simple process to help diagnose or monitor health conditions. You may feel a small prick, but discomfort is minimal.
60 services49 patients
Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more 99215
This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.
46 services40 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.
34 services33 patients

Hospital Affiliations CMS Care Compare

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

Uf Health Shands Hospital

Acute Care Hospitals · Gainesville, FL
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number100113
Location1600 SW Archer RdGainesville, FL 32610 · Alachua County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 32610 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
$171.84 typical visit price
range $56.00 – $171.84
Typical copayment $42.96 (range $14.00 – $42.96)
Most-billed visit code 99205
Established Patient
$99.16 typical visit price
range $17.57 – $139.16
Typical copayment $24.79 (range $4.39 – $34.79)
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.

78.18/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality72.54
Promoting Interoperability100
Improvement Activities40
Cost54.74

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.

DR. BAHAREH EBADIFAR KEITH DO
Pediatrics
1600 SW ARCHER RD
GAINESVILLE, FL 32610
Alachua County (352) 273-0462
AFRASYAB KHAN
Surgery
1600 SW ARCHER RD
GAINESVILLE, FL 32610
Alachua County (352) 265-0680
GULSUN ERDAG MD
Pathology (Anatomic Pathology & Clinical Pathology)
1600 SW ARCHER RD
GAINESVILLE, FL 32610
Alachua County (352) 265-9900
DR. ALBERT H. MATTIA D.D.S.
Dentist (Prosthodontics)
1600 SW ARCHER RD, D4-4
GAINESVILLE, FL 32610
Alachua County (352) 273-5801
JOANNA CHAFFIN
Pathology (Anatomic Pathology & Clinical Pathology)
1600 SW ARCHER RD
GAINESVILLE, FL 32610
Alachua County (352) 627-9272
DR. CASEY JUSTIN BEAL MD
Ophthalmology
1600 SW ARCHER RD, BOX 100284
GAINESVILLE, FL 32610
Alachua County (352) 273-8778
WILLIAM CRAIG HICKS CRNA
Nurse Anesthetist, Certified Registered
1600 SW ARCHER RD
GAINESVILLE, FL 32610
Alachua County (352) 273-6438
HENRY FONTILLAS PATALINGHUG CRNA
Nurse Anesthetist, Certified Registered
1600 SW ARCHER RD
GAINESVILLE, FL 32610
Alachua County (352) 273-6438

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 Carol Mathew's NPI number?

The NPI number for Carol Mathew is 1104265438. It was assigned to this individual provider in the NPPES registry on June 20, 2013.

Where is Carol Mathew located?

Carol Mathew practices at 1600 SW Archer Rd, Gainesville, FL 32610. The listed phone number is (352) 265-0301.

What is Carol Mathew's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Hematology & Oncology, with taxonomy code 207RH0003X.

Is Carol Mathew enrolled in Medicare?

Yes. Carol Mathew 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 Carol Mathew accept?

Health plans from AvMed, Florida Blue (BlueCross BlueShield FL), Florida Blue HMO (a BlueCross BlueShield FL company) and Molina Healthcare list Carol Mathew 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 Carol Mathew affiliated with any hospitals?

According to CMS data, Carol Mathew is affiliated with Uf Health Shands Hospital.

When was this NPI record last updated?

The NPPES record for Carol Mathew was last updated on September 4, 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.