MATTHEW D. KARL MD
NPI 1154716959
Ophthalmology - Retina Specialist in East Setauket, NY

Active since March 30, 2015PECOS EnrolledAccepts Medicare Assignment
96.64/100
CMS Quality Rating
33 RESEARCH WAY STE 13, EAST SETAUKET, NY 11733(631) 444-0650(614) 293-4719 Get Directions Write a Review

NPPES record last updated: January 4, 2023. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jan 4, 2023, Dec 22, 2022, Jan 29, 2021 and 2 more (5 updates tracked since 2019).

About Matthew D. Karl Md NPPES

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

MATTHEW D. KARL MD (NPI 1154716959) is an individual retina specialist in East Setauket, New York, licensed in New York (291790) and active in the NPI registry since March 2015. He is enrolled in Medicare PECOS, is affiliated with North Shore University Hospital, and is a graduate of State University Of New York Downstate Medical Center (2015).

NPPES Registry Identity

NPI1154716959
Entity TypeIndividualMale
Primary Taxonomy207WX0107X
Provider Legal NameMATTHEW D. KARLCredential: MD
Location Address33 RESEARCH WAY STE 13East Setauket, NY 11733-3489
Mailing Address33 Research Way Ste 13East Setauket, NY 11733-3489 · (631) 444-0650 · Fax (614) 293-4719
Fax(614) 293-4719
Sole ProprietorNo
Medical School CMSState University Of New York Downstate Medical CenterGraduated 2015
Enumeration DateMarch 30, 2015
Last NPPES UpdateJanuary 4, 20235 updates tracked since enumeration
NPPES CertifiedJanuary 4, 2023
NPI 1154716959 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtyOphthalmology · Retina SpecialistAllopathic & Osteopathic Physicians
Taxonomy Code207WX0107X
Licenses Licensed in NY · 291790 Licensed in OH · 35135581
Definition
An ophthalmologist who specializes in the diagnosis and treatment of vitreoretinal diseases.
Also ListedOphthalmologyTaxonomy 207W00000X · License 35135581 (OH)
33 RESEARCH WAY STE 13, East Setauket, NY 11733

Other Identifiers 1

Medicaid0359260OH

Accepted 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

Matthew D. Karl Md 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 ID8224375357
PECOS Enrollment IDI20220817001060
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 20

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.

Injection, faricimab-svoa, 0.1 mg J2777
Faricimab-svoa is a medication given through an injection into the eye to treat certain eye conditions. The 0.1 mg dosage helps control disease progression, improving vision and eye health. The procedure is done by a healthcare professional.
34,971 services134 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.
3,092 services1,484 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.
1,161 services318 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.
947 services870 patients
Injection, aflibercept, 1 mg J0178
Aflibercept injection is a treatment for certain eye conditions that affect vision. It works by blocking abnormal blood vessel growth and leakage in the eye, which can cause vision loss. The medication is administered directly into the eye by a healthcare professional.
922 services173 patients
Established patient problem focused exam of visual system 92012
This is a routine check-up for existing patients focusing on the visual system. It involves examining your eyes to detect any potential issues or changes in your vision. It's a crucial part of maintaining good eye health.
659 services506 patients

Hospital Affiliations CMS Care Compare

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

North Shore University Hospital

Acute Care Hospitals · Manhasset, NY
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number330106
Location300 Community DriveManhasset, NY 11030 · Nassau County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 11733 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
$154.28 typical visit price
range $67.40 – $203.53
Typical copayment $38.57 (range $16.85 – $50.88)
Most-billed visit code 99204
Established Patient
$83.44 typical visit price
range $21.66 – $164.45
Typical copayment $20.86 (range $5.41 – $41.11)
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.

96.64/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality100
Improvement Activities40
Cost88.81

Other Providers at the Same Location NPPES 7

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

Student in an Organized Health Care Education/Training Program
33 RESEARCH WAY STE 13
EAST SETAUKET, NY 11733
Ophthalmology
33 RESEARCH WAY STE 13
EAST SETAUKET, NY 11733
Ophthalmology
33 RESEARCH WAY STE 13
EAST SETAUKET, NY 11733
Ophthalmology
33 RESEARCH WAY STE 13
EAST SETAUKET, NY 11733
Student in an Organized Health Care Education/Training Program
33 RESEARCH WAY STE 13
EAST SETAUKET, NY 11733
Psychiatry & Neurology (Neurology)
33 RESEARCH WAY STE 13
EAST SETAUKET, NY 11733
Ophthalmology (Pediatric Ophthalmology and Strabismus Specialist)
33 RESEARCH WAY STE 13
EAST SETAUKET, NY 11733

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 Karl's NPI number?

The NPI number for Matthew Karl is 1154716959. It was assigned to this individual provider in the NPPES registry on March 30, 2015.

Where is Matthew Karl located?

Matthew Karl practices at 33 Research Way Ste 13, East Setauket, NY 11733. The listed phone number is (631) 444-0650.

What is Matthew Karl's specialty?

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

Is Matthew Karl enrolled in Medicare?

Yes. Matthew Karl 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 Matthew Karl accept?

Health plans from Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma, Blue Cross and Blue Shield of Texas and Oscar Insurance Company list Matthew Karl 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 Karl affiliated with any hospitals?

According to CMS data, Matthew Karl is affiliated with North Shore University Hospital.

When was this NPI record last updated?

The NPPES record for Matthew Karl was last updated on January 4, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.