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DR. MAMATHA K AGRAWAL M.D.
NPI 1205864659
Family Medicine in Raleigh, NC

Active since June 28, 2006PECOS EnrolledAccepts Medicare Assignment
4551 NEW BERN AVE # A100, RALEIGH, NC 27610(984) 215-4960(984) 215-4965 Get Directions Write a Review

NPPES record last updated: May 4, 2021. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: May 4, 2021, Apr 7, 2021, Jun 16, 2020 and 1 more (4 updates tracked since 2019).

About Dr. Mamatha K Agrawal M.d. NPPES

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

DR. MAMATHA K AGRAWAL M.D. (NPI 1205864659) is an individual family medicine provider in Raleigh, North Carolina, licensed in North Carolina (200000169) and active in the NPI registry since June 2006. She is enrolled in Medicare PECOS, is affiliated with Rex Hospital, and is a graduate of Northwestern University Feinberg Medical School (1997).

NPPES Registry Identity

NPI1205864659
Entity TypeIndividualFemale
Primary Taxonomy207Q00000X
Provider Legal NameDR. MAMATHA K AGRAWALCredential: M.D.
Location Address4551 NEW BERN AVE # A100Raleigh, NC 27610-1551
Mailing Address4551 New Bern Ave # A100Raleigh, NC 27610-1551 · (984) 215-4950 · Fax (984) 215-4955
Phone(984) 215-4960
Fax(984) 215-4965
Sole ProprietorNo
Medical School CMSNorthwestern University Feinberg Medical SchoolGraduated 1997
Enumeration DateJune 28, 2006
Last NPPES UpdateMay 4, 20214 updates tracked since enumeration
NPPES CertifiedMay 4, 2021
✔ NPI 1205864659 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in NC · 200000169
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
4551 NEW BERN AVE # A100, Raleigh, NC 27610
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Other Identifiers 10

Other116335NC · Aetna Hmo
Other8443512NC · Cigna
Other010066307NC · Railroad Medicare
Other127VUNC · Bcbs
Other7478171NC · Aetna Ppo
Other171525NC · Wellpath
Other0156615NC · Uhc
Medicaid89127VUNC
Other228096NC · Mamsi
OtherB4846NC · Medcost

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of NC, 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

Dr. Mamatha K Agrawal 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 ID8820988777
PECOS Enrollment IDI20110927000823
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 6

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.
122 services66 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.
34 services22 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.
30 services27 patients
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439
An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.
22 services22 patients
Administration of influenza virus vaccine G0008
The administration of the influenza virus vaccine, also known as the flu shot, is a simple procedure to protect against the flu. A healthcare provider injects a small dose of the vaccine into your arm. This stimulates your immune system to produce antibodies, which will help your body fight off the flu if exposed.
12 services12 patients
New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203
This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.
11 services11 patients

Hospital Affiliations CMS Care Compare

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

Rex Hospital

Acute Care Hospitals · Raleigh, NC
5/5 CMS rating
OwnershipGovernment - State
CMS Certification Number340114
Location4420 Lake Boone TrailRaleigh, NC 27607 · Wake County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 27610 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
$83.90 typical visit price
range $54.12 – $165.09
Typical copayment $20.97 (range $13.53 – $41.27)
Most-billed visit code 99203
Established Patient
$95.94 typical visit price
range $17.21 – $134.61
Typical copayment $23.98 (range $4.30 – $33.65)
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.

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 Mamatha Agrawal's NPI number?

The NPI number for Mamatha Agrawal is 1205864659. It was assigned to this individual provider in the NPPES registry on June 28, 2006.

Where is Mamatha Agrawal located?

Mamatha Agrawal practices at 4551 New Bern Ave # A100, Raleigh, NC 27610. The listed phone number is (984) 215-4960.

What is Mamatha Agrawal's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Mamatha Agrawal enrolled in Medicare?

Yes. Mamatha Agrawal 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 Mamatha Agrawal accept?

Health plans from Blue Cross and Blue Shield of NC and UnitedHealthcare list Mamatha Agrawal 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 Mamatha Agrawal affiliated with any hospitals?

According to CMS data, Mamatha Agrawal is affiliated with Rex Hospital.

When was this NPI record last updated?

The NPPES record for Mamatha Agrawal was last updated on May 4, 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.