DR. MATTHEW WILLIAM LOUGHLIN M.D.
NPI 1255307401
Urology in The Villages, FL

Q: What is Matthew Loughlin's NPI number?

The NPI number for Matthew Loughlin is 1255307401. It was assigned to this individual provider in the NPPES registry on February 27, 2006.

Q: What is Matthew Loughlin's specialty?

The primary specialty registered for this NPI is Urology with taxonomy code 208800000X.

Q: When was this NPI record last updated?

The NPPES record for Matthew Loughlin was last updated on February 21, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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 February 27, 2006PECOS Enrolled

75/100

CMS Quality Rating

1580 SANTA BARBARA BLVD, THE VILLAGES, FL 32159(352) 259-2159(352) 259-5731 Get Directions Write a Review

NPPES record last updated: February 21, 2020. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Feb 21, 2020, Feb 8, 2016 (2 updates tracked since 2016).

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About Dr. Matthew William Loughlin M.d. NPPES

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

DR. MATTHEW WILLIAM LOUGHLIN M.D. (NPI 1255307401) is an individual urology provider in The Villages, Florida, licensed in Florida (ME87080) and active in the NPI registry since February 2006. He is enrolled in Medicare PECOS and maintains a secondary practice location in Brandon.

NPPES Registry Identity

NPI1255307401

Entity TypeIndividualMale

Primary Taxonomy208800000X

Provider Legal NameDR. MATTHEW WILLIAM LOUGHLINCredential: M.D.

Location Address1580 SANTA BARBARA BLVDThe Villages, FL 32159-6827

Mailing Address1580 Santa Barbara BlvdThe Villages, FL 32159-6827 · (352) 259-2159 · Fax (352) 259-5731

Phone(352) 259-2159

Fax(352) 259-5731

Sole ProprietorNo

Enumeration DateFebruary 27, 2006

Last NPPES UpdateFebruary 21, 20202 updates tracked since enumeration

✔ NPI 1255307401 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyUrologyAllopathic & Osteopathic Physicians

Taxonomy Code208800000X

License✔ Licensed in FL · ME87080

Definition

A urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures.

1580 SANTA BARBARA BLVD, The Villages, FL 32159

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Secondary Practice Location 1

Location 1620 Eichenfeld DrBrandon, FL 33511-5973 · Phone (813) 653-3737 · Fax (813) 653-2525

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Matthew William Loughlin M.d. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

Medicare Billing Reassignments

Medicare enrollment records show Matthew Loughlin reassigns Medicare billing to 3 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Gastro-Intestinal Consultants Of Central Florida, LLC

16 mi

Gastroenterology

2134 VINDALE RD
Tavares, FL 32778

Reassigned Medicare billing, Florida enrollment
5 clinicians in this Medicare group

NPI 1982642922 (352) 383-7703

North Florida Urology Associates Inc

19 mi

Urology

3201 SW 34TH ST
Ocala, FL 34474

Reassigned Medicare billing, Florida enrollment
9 clinicians in this Medicare group

NPI 1215117528 (352) 456-7911

Florida Urology Oncology And Urogynecology LLC

73 mi

Urology

215 LITHIA PINECREST RD
Brandon, FL 33511

Reassigned Medicare billing, Florida enrollment
2 clinicians in this Medicare group

NPI 1689970972 (813) 681-2300

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 32159 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

$130.04 typical visit price

range $56.00 – $171.84

Typical copayment $32.51 (range $14.00 – $42.96)

Most-billed visit code 99204

Established Patient

$70.04 typical visit price

range $17.57 – $139.16

Typical copayment $17.51 (range $4.39 – $34.79)

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.

75/100

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

Individually scored

Reported Quality Measures

Documentation of Current Medications in the Medical Record

Percentage of visits for patients aged 18 years and older for which the eligible professional or eligible clinician attests to documenting a list of current medications using all immediate resources available on the date of the encounter.

91%32 patients4/55-star benchmark: 100%

Medication Reconciliation

The MIPS eligible clinician performs medication reconciliation for at least one transition of care in which the patient is transitioned into the care of the MIPS eligible clinician.

47%1,339 patients1/55-star benchmark: 100%

Patient-Specific Education

The MIPS eligible clinician must use clinically relevant information from CEHRT to identify patient-specific educational resources and provide access to those materials to at least one unique patient seen by the MIPS eligible clinician.

61%1,017 patients3/55-star benchmark: 99%

Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan

Percentage of patients aged 18 years and older with a BMI documented during the current encounter or during the previous twelve months AND with a BMI outside of normal parameters, a follow-up plan is documented during the encounter or during the previous…

4%28 patients1/55-star benchmark: 97%

Provide Patient Access

At least one patient seen by the MIPS eligible clinician during the performance period is provided timely access to view online, download, and transmit to a third party their health information subject to the MIPS eligible clinician's discretion to withhold…

29%1,017 patients2/55-star benchmark: 100%

Secure Messaging

For at least one unique patient seen by the MIPS eligible clinician during the performance period, a secure message was sent using the electronic messaging function of CEHRT to the patient (or the patient-authorized representative), or in response to a secure…

0%1,017 patients1/55-star benchmark: 59%

Use of High-Risk Medications in the Elderly

Percentage of patients 65 years of age and older who were ordered high-risk medications. Two rates are submitted. 1) Percentage of patients who were ordered at least one high-risk medication.

Lower rates are better for this measure.

Patients 2+: 0% · 22 patients

0%22 patients5/55-star benchmark: 100%

Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Referred Medical Equipment & Supplies CMS DME claims

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

Intermittent urinary catheter; straight tip, with or without coating (teflon, silicone, silicone elastomer, or hydrophilic, etc.), each A4351

DME-Orthotic Devices · category DF008N

5 suppliers21 claims6,260 services$1.71 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.

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