DR. STEPHEN CARL MATHAI MD MHS
NPI 1235242314
Internal Medicine - Pulmonary Disease in Baltimore, MD

Q: What is Stephen Mathai's NPI number?

The NPI number for Stephen Mathai is 1235242314. It was assigned to this individual provider in the NPPES registry on August 16, 2006.

Q: What is Stephen Mathai's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Pulmonary Disease, with taxonomy code 207RP1001X.

Q: When was this NPI record last updated?

The NPPES record for Stephen Mathai was last updated on February 12, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 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.

Active since August 16, 2006PECOS Enrolled

74.39/100

CMS Quality Rating

4940 EASTERN AVE, BALTIMORE, MD 21224(410) 550-5864 Get Directions Write a Review

NPPES record last updated: February 12, 2013. Verified against the NPPES registry weekly; last sync: August 16, 2026.

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About Dr. Stephen Carl Mathai Md Mhs NPPES

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

DR. STEPHEN CARL MATHAI MD MHS (NPI 1235242314) is an individual pulmonary disease provider in Baltimore, Maryland, licensed in Maryland (D60811) and active in the NPI registry since August 2006. He is enrolled in Medicare PECOS, is affiliated with Johns Hopkins Hospital, The, and is a graduate of Jefferson Medical College Of Thomas Jefferson University (1999).

NPPES Registry Identity

NPI1235242314

Entity TypeIndividualMale

Primary Taxonomy207RP1001X

Provider Legal NameDR. STEPHEN CARL MATHAICredential: MD MHS

Location Address4940 EASTERN AVEBaltimore, MD 21224-2735

Mailing AddressPo Box 64264Baltimore, MD 21264-4264 · (410) 550-5864

Phone(410) 550-5864

Sole ProprietorNo

Medical School CMSJefferson Medical College Of Thomas Jefferson UniversityGraduated 1999

Enumeration DateAugust 16, 2006

Last NPPES UpdateFebruary 12, 2013

✔ NPI 1235242314 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyInternal Medicine · Pulmonary DiseaseAllopathic & Osteopathic Physicians

Taxonomy Code207RP1001X

License✔ Licensed in MD · D60811

Definition

An internist who treats diseases of the lungs and airways. The pulmonologist diagnoses and treats cancer, pneumonia, pleurisy, asthma, occupational and environmental diseases, bronchitis, sleep disorders, emphysema and other complex disorders of the lungs.

Also ListedInternal MedicineTaxonomy 207R00000X · License D0060811 (MD)

4940 EASTERN AVE, Baltimore, MD 21224

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Other Identifiers 2

Medicaid405712100MD

Medicare PIN134620YVBMD

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Stephen Carl Mathai Md Mhs is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID6103880778

PECOS Enrollment IDI20041113000097

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.

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.

172 services64 patients

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes 99233

Follow-up hospital inpatient care per day typically involves a 35-minute check-up by your healthcare provider. This service includes monitoring your health progress, adjusting your treatment plan if needed, and answering any questions you may have about your condition or care.

145 services59 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.

118 services65 patients

Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes 99223

Initial hospital inpatient care per day, typically 70 minutes, refers to the daily medical service provided to patients admitted to the hospital. This includes a comprehensive evaluation, diagnosis, treatment plan, and monitoring of your health condition. It ensures your well-being during your hospital stay.

38 services38 patients

New patient office or other outpatient visit with a high level of medical decision making, if using time, 60 minutes or more 99205

This is a first-time patient visit where a healthcare professional spends 60-74 minutes with you. It involves a comprehensive evaluation, including your medical history and current health condition. They'll also advise on preventive health measures and formulate a treatment plan if needed.

16 services16 patients

Prolonged office or other outpatient evaluation and management service(s) beyond the maximum required time of the primary procedure which has been selected using total time on the date of the primary service; each additional 15 minutes by the physician or G2212

This service refers to extended doctor visits where your healthcare provider spends additional time evaluating and managing your health beyond the primary procedure's required time. This includes each extra 15 minutes spent by the physician on the same day as the primary service.

15 services11 patients

Hospital Affiliations CMS Care Compare 2

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

Johns Hopkins Hospital, The

Acute Care Hospitals · Baltimore, MD

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number210009

Location600 North Wolfe StreetBaltimore, MD 21287 · Baltimore City County

Emergency services Birthing friendly

Johns Hopkins Bayview Medical Center

Acute Care Hospitals · Baltimore, MD

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number210029

Location4940 Eastern AvenueBaltimore, MD 21224 · Baltimore City County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 21224 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

$139.05 typical visit price

range $60.73 – $183.44

Typical copayment $34.76 (range $15.18 – $45.86)

Most-billed visit code 99204

Established Patient

$106.59 typical visit price

range $19.60 – $149.17

Typical copayment $26.64 (range $4.90 – $37.29)

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.

74.39/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored as part of a group practice

Quality

64.71

Promoting Interoperability

Improvement Activities

Cost

52.43

Referred Medical Equipment & Supplies CMS DME claims 6

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 suppliers17 claims17 services$14.46 avg. paid by Medicare

Ultrasonic/electronic aerosol generator with small volume nebulizer E0574

DME-Other DME · category DE000N

1 supplier11 claims11 services$31.02 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 suppliers62 claims65 services$66.34 avg. paid by Medicare

Portable oxygen concentrator, rental E1392

DME-Oxygen and Supplies · category DC002N

3 suppliers46 claims48 services$33.30 avg. paid by Medicare

Treprostinil, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose form, 1.74 mg J7686

DME-Drugs Administered Through DME · category DG004N

1 supplier29 claims812 services$549.80 avg. paid by Medicare

Pharmacy dispensing fee for inhalation drug(s); per 30 days Q0513

DME-Other DME · category DE000N

1 supplier28 claims28 services$26.03 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.

DR. SUSRUTHA KOTWAL MD

Internal Medicine

4940 EASTERN AVE, MFL BLDG, WEST TOWER, 6TH FLOOR
BALTIMORE, MD 21224

Baltimore City (410) 550-5018

DR. SAMANTHA A WOLFE MD

Otolaryngology