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MATTHEW HENSLEY
NPI 1174865596
Internal Medicine - Critical Care Medicine in Pittsburgh, PA

Active since March 24, 2013PECOS EnrolledAccepts Medicare Assignment
77.5/100
CMS Quality Rating
5200 CENTRE AVE, PITTSBURGH, PA 15232(412) 621-1200 Get Directions Write a Review

NPPES record last updated: March 25, 2021. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Mar 25, 2021, May 28, 2020 (2 updates tracked since 2020).

About Matthew Hensley NPPES

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

MATTHEW HENSLEY (NPI 1174865596) is an individual critical care medicine provider in Pittsburgh, Pennsylvania, licensed in Pennsylvania (MD469637) and active in the NPI registry since March 2013. He is enrolled in Medicare PECOS, is affiliated with Upmc Passavant, and is a graduate of University Of Kentucky College Of Medicine (2013).

NPPES Registry Identity

NPI1174865596
Entity TypeIndividualMale
Primary Taxonomy207RC0200X
Provider Legal NameMATTHEW HENSLEY
Location Address5200 CENTRE AVEPittsburgh, PA 15232-1300
Mailing Address5200 Centre AvePittsburgh, PA 15232-1300
Phone(412) 621-1200
Sole ProprietorNo
Medical School CMSUniversity Of Kentucky College Of MedicineGraduated 2013
Enumeration DateMarch 24, 2013
Last NPPES UpdateMarch 25, 20212 updates tracked since enumeration
NPPES CertifiedMay 28, 2020
✔ NPI 1174865596 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · Critical Care MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207RC0200X
License✔ Licensed in PA · MD469637
Definition
An internist who diagnoses, treats and supports patients with multiple organ dysfunction. This specialist may have administrative responsibilities for intensive care units and may also facilitate and coordinate patient care among the primary physician, the critical care staff and other specialists.
5200 CENTRE AVE, Pittsburgh, PA 15232
Open in Google Maps ↗

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 Hensley 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 ID6507085487
PECOS Enrollment IDI20200429000043
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.

Critical care, first 30-74 minutes 99291
Critical care involves immediate and constant attention by a team of specially-trained health professionals. It's for patients with life-threatening conditions, requiring first 30-74 minutes of intense monitoring and treatment.
71 services38 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.
55 services40 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.
42 services32 patients

Hospital Affiliations CMS Care Compare 3

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

Upmc Passavant

Acute Care Hospitals · Pittsburgh, PA
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number390107
Location9100 Babcock BoulevardPittsburgh, PA 15237 · Allegheny County
Emergency services

Magee Womens Hospital Of Upmc Health System

Acute Care Hospitals · Pittsburgh, PA
3/5 CMS rating
OwnershipVoluntary non-profit - Other
CMS Certification Number390114
Location300 Halket StreetPittsburgh, PA 15213 · Allegheny County
Emergency services Birthing friendly

Upmc Presbyterian Shadyside

Acute Care Hospitals · Pittsburgh, PA
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number390164
Location200 Lothrop StreetPittsburgh, PA 15213 · Allegheny County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 15232 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
$126.34 typical visit price
range $54.64 – $166.87
Typical copayment $31.58 (range $13.66 – $41.71)
Most-billed visit code 99204
Established Patient
$96.82 typical visit price
range $17.33 – $135.84
Typical copayment $24.20 (range $4.33 – $33.96)
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.

77.5/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality68.61
Promoting Interoperability100
Improvement Activities40
Cost56.4

Referred Medical Equipment & Supplies CMS DME claims 5

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing E0431
DME-Oxygen and Supplies · category DC000N
2 suppliers13 claims13 services$15.19 avg. paid by Medicare
Nebulizer, with compressor E0570
DME-Other DME · category DE000N
1 supplier15 claims15 services$3.55 avg. paid by Medicare
Continuous positive airway pressure (cpap) device E0601
DME-Other DME · category DE001N
1 supplier18 claims18 services$29.86 avg. paid by Medicare
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate E1390
DME-Oxygen and Supplies · category DC002N
4 suppliers20 claims20 services$62.18 avg. paid by Medicare
Portable oxygen concentrator, rental E1392
DME-Oxygen and Supplies · category DC002N
1 supplier12 claims12 services$34.71 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

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.

KRISHNA KANCHARLA
Internal Medicine (Clinical Cardiac Electrophysiology)
5200 CENTRE AVE, SUITE 710
PITTSBURGH, PA 15232
Allegheny County (412) 623-6889
EMILY YEE
Internal Medicine (Pulmonary Disease)
5200 CENTRE AVE, SHADYSIDE MEDICAL BUILDING, SUITE 610
PITTSBURGH, PA 15232
Allegheny County (412) 621-1200
HITENDRA PATEL
Legal Medicine
5200 CENTRE AVE, SUITE 312
PITTSBURGH, PA 15232
Allegheny County (412) 621-7777
STEPHANIE RICHARDS
Specialist
5200 CENTRE AVE, SUITE 405
PITTSBURGH, PA 15232
Allegheny County (412) 623-2700
HARRY RAFKIN
Internal Medicine (Pulmonary Disease)
5200 CENTRE AVE, SUITE 610
PITTSBURGH, PA 15232
Allegheny County (412) 621-1200
DR. MARK RIZKO MD
Student in an Organized Health Care Education/Training Program
5200 CENTRE AVE
PITTSBURGH, PA 15232
Allegheny County (412) 623-2121
TINA MUSAHL
Internal Medicine (Gastroenterology)
5200 CENTRE AVE, SUITE 312
PITTSBURGH, PA 15232
Allegheny County (412) 621-7777
JOEL BIGLEY
Urology
5200 CENTRE AVE, MEDICAL ARTS BUILDING, SUITE 209
PITTSBURGH, PA 15232
Allegheny County (412) 605-3000

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 Hensley's NPI number?

The NPI number for Matthew Hensley is 1174865596. It was assigned to this individual provider in the NPPES registry on March 24, 2013.

Where is Matthew Hensley located?

Matthew Hensley practices at 5200 Centre Ave, Pittsburgh, PA 15232. The listed phone number is (412) 621-1200.

What is Matthew Hensley's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Critical Care Medicine, with taxonomy code 207RC0200X.

Is Matthew Hensley enrolled in Medicare?

Yes. Matthew Hensley 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.

Is Matthew Hensley affiliated with any hospitals?

According to CMS data, Matthew Hensley is affiliated with Upmc Passavant, Magee Womens Hospital Of Upmc Health System and Upmc Presbyterian Shadyside.

When was this NPI record last updated?

The NPPES record for Matthew Hensley was last updated on March 25, 2021. 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.