DR. MATTHEW RYAN GRAFENBERG M.D.
NPI 1225001357
Otolaryngology in Pinehurst, NC

Active since February 09, 2006PECOS EnrolledAccepts Medicare Assignment
87.95/100
CMS Quality Rating
5 FIRSTVILLAGE DRIVE, PINEHURST, NC 28374(910) 295-6831(910) 295-0244 Get Directions Write a Review

NPPES record last updated: September 11, 2018. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Dr. Matthew Ryan Grafenberg M.d. NPPES

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

DR. MATTHEW RYAN GRAFENBERG M.D. (NPI 1225001357) is an individual otolaryngology provider in Pinehurst, North Carolina, licensed in North Carolina (2008-00324) and active in the NPI registry since February 2006. He is enrolled in Medicare PECOS, is affiliated with Firsthealth Moore Regional Hospital, and is a graduate of Uniformed Services Uhs Fe Hebert School Of Med (2002).

NPPES Registry Identity

NPI1225001357
Entity TypeIndividualMale
Primary Taxonomy207Y00000X
Provider Legal NameDR. MATTHEW RYAN GRAFENBERGCredential: M.D.
Location Address5 FIRSTVILLAGE DRIVEPinehurst, NC 28374
Mailing Address5 Firstvillage Drive, Po Box 2000Pinehurst, NC 28374 · (910) 295-6831 · Fax (910) 295-0244
Fax(910) 295-0244
Sole ProprietorNo
Medical School CMSUniformed Services Uhs Fe Hebert School Of MedGraduated 2002
Enumeration DateFebruary 9, 2006
Last NPPES UpdateSeptember 11, 2018
NPI 1225001357 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyOtolaryngologyAllopathic & Osteopathic Physicians
Taxonomy Code207Y00000X
License Licensed in NC · 2008-00324
Definition

An otolaryngologist-head and neck surgeon provides comprehensive medical and surgical care for patients with diseases and disorders that affect the ears, nose, throat, the respiratory and upper alimentary systems and related structures of the head and neck. An otolaryngologist diagnoses and provides medical and/or surgical therapy or prevention of diseases, allergies, neoplasms, deformities, disorders and/or injuries of the ears, nose, sinuses, throat, respiratory and upper alimentary systems, face, jaws and the other head and neck systems. Head and neck oncology, facial plastic and reconstructive surgery and the treatment of disorders of hearing and voice are fundamental areas of expertise.

5 FIRSTVILLAGE DRIVE, Pinehurst, NC 28374

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

Dr. Matthew Ryan Grafenberg 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 ID446311195
PECOS Enrollment IDI20081212000542
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 18

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 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.
428 services295 patients
Professional service for preparation and provision of 1 or more antigens 95165
This service involves the creation and supply of antigens, substances that stimulate your immune system to fight diseases. These antigens can be used in vaccines or allergy tests to help your body build defenses against specific health threats.
400 services17 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.
219 services219 patients
Professional service for multiple injections of allergen 95117
The professional service for multiple injections of allergens involves administering small doses of specific allergens into your body. This is done to help your immune system become less sensitive to them, reducing your allergic reaction over time. It's a safe, effective way to manage allergies.
127 services11 patients
Removal of impacted ear wax 69210
Impacted ear wax removal is a safe procedure to clear blockages in the ear canal caused by hardened ear wax. A healthcare professional uses specialized tools or a gentle irrigation method to loosen and remove the wax, improving hearing and alleviating discomfort.
100 services86 patients
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.
88 services76 patients

Hospital Affiliations CMS Care Compare

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

Firsthealth Moore Regional Hospital

Acute Care Hospitals · Pinehurst, NC
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number340115
Location155 Memorial DrivePinehurst, NC 28374 · Moore County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 28374 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
$125.01 typical visit price
range $54.12 – $165.09
Typical copayment $31.25 (range $13.53 – $41.27)
Most-billed visit code 99204
Established Patient
$67.72 typical visit price
range $17.21 – $134.61
Typical copayment $16.93 (range $4.30 – $33.65)
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.

87.95/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality76.57
Promoting Interoperability100
Improvement Activities40
Cost83.28

Referred Medical Equipment & Supplies CMS DME claims 13

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

Tubing with integrated heating element for use with positive airway pressure device A4604
DME-Other DME · category DE001N
13 suppliers115 claims115 services$40.96 avg. paid by Medicare
Full face mask used with positive airway pressure device, each A7030
DME-Other DME · category DE001N
12 suppliers112 claims112 services$101.25 avg. paid by Medicare
Face mask interface, replacement for full face mask, each A7031
DME-Other DME · category DE001N
12 suppliers98 claims261 services$39.19 avg. paid by Medicare
Cushion for use on nasal mask interface, replacement only, each A7032
DME-Other DME · category DE001N
7 suppliers28 claims146 services$19.85 avg. paid by Medicare
Pillow for use on nasal cannula type interface, replacement only, pair A7033
DME-Other DME · category DE001N
7 suppliers28 claims155 services$16.49 avg. paid by Medicare
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap A7034
DME-Other DME · category DE001N
10 suppliers68 claims68 services$60.05 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.

Nurse Practitioner
5 FIRSTVILLAGE DRIVE
PINEHURST, NC 28374
Surgery
5 FIRSTVILLAGE DRIVE
PINEHURST, NC 28374
Urology
5 FIRSTVILLAGE DRIVE
PINEHURST, NC 28374
Urology
5 FIRSTVILLAGE DRIVE
PINEHURST, NC 28374
Urology
5 FIRSTVILLAGE DRIVE
PINEHURST, NC 28374
Orthopaedic Surgery
5 FIRSTVILLAGE DRIVE
PINEHURST, NC 28374
Surgery
5 FIRSTVILLAGE DRIVE
PINEHURST, NC 28374
Surgery
5 FIRSTVILLAGE DRIVE
PINEHURST, NC 28374

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 Grafenberg's NPI number?

The NPI number for Matthew Grafenberg is 1225001357. It was assigned to this individual provider in the NPPES registry on February 9, 2006.

Where is Matthew Grafenberg located?

Matthew Grafenberg practices at 5 Firstvillage Drive, Pinehurst, NC 28374. The listed phone number is (910) 295-6831.

What is Matthew Grafenberg's specialty?

The primary specialty registered for this NPI is Otolaryngology with taxonomy code 207Y00000X.

Is Matthew Grafenberg enrolled in Medicare?

Yes. Matthew Grafenberg 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 Grafenberg accept?

Health plans from Ambetter from Absolute Total Care, Ambetter of North Carolina, Ambetter of Tennessee, AmeriHealth Caritas Next and Blue Cross and Blue Shield of NC and 1 other insurer list Matthew Grafenberg 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 Grafenberg affiliated with any hospitals?

According to CMS data, Matthew Grafenberg is affiliated with Firsthealth Moore Regional Hospital.

When was this NPI record last updated?

The NPPES record for Matthew Grafenberg was last updated on September 11, 2018. NPI Profile syncs with the weekly NPPES data releases published by CMS.