NATHAN R MATHEWS MD
NPI 1275928624
Ophthalmology in Burlington, WI

Q: What is Nathan Mathews's NPI number?

The NPI number for Nathan Mathews is 1275928624. It was assigned to this individual provider in the NPPES registry on April 2, 2015.

Q: What is Nathan Mathews's specialty?

The primary specialty registered for this NPI is Ophthalmology with taxonomy code 207W00000X.

Q: When was this NPI record last updated?

The NPPES record for Nathan Mathews was last updated on August 18, 2023. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since April 02, 2015PECOS EnrolledAccepts Medicare Assignment

70.27/100

CMS Quality Rating

675 W STATE ST, BURLINGTON, WI 53105(262) 763-7613(262) 947-4996 Get Directions Write a Review

NPPES record last updated: August 18, 2023. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Aug 18, 2023, Jul 14, 2022, Mar 9, 2021 and 2 more (5 updates tracked since 2016).

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About Nathan R Mathews Md NPPES

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

NATHAN R MATHEWS MD (NPI 1275928624) is an individual ophthalmology provider in Burlington, Wisconsin, licensed in Wisconsin (68043-20) and active in the NPI registry since April 2015. He is enrolled in Medicare PECOS, is affiliated with Aurora Memorial Hospital Burlington, and maintains a secondary practice location in Elkhorn.

NPPES Registry Identity

NPI1275928624

Entity TypeIndividualMale

Primary Taxonomy207W00000X

Provider Legal NameNATHAN R MATHEWSCredential: MD

Location Address675 W STATE STBurlington, WI 53105-1739

Mailing Address675 W State StBurlington, WI 53105-1739 · (262) 763-7772 · Fax (262) 763-7002

Phone(262) 763-7613

Fax(262) 947-4996

Sole ProprietorNo

Medical School CMSMedical College Of WisconsinGraduated 2015

Enumeration DateApril 2, 2015

Last NPPES UpdateAugust 18, 20235 updates tracked since enumeration

NPPES CertifiedAugust 18, 2023

✔ NPI 1275928624 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOphthalmologyAllopathic & Osteopathic Physicians

Taxonomy Code207W00000X

License✔ Licensed in WI · 68043-20

Definition

An ophthalmologist has the knowledge and professional skills needed to provide comprehensive eye and vision care. Ophthalmologists are medically trained to diagnose, monitor and medically or surgically treat all ocular and visual disorders. This includes problems affecting the eye and its component structures, the eyelids, the orbit and the visual pathways. In so doing, an ophthalmologist prescribes vision services, including glasses and contact lenses.

675 W STATE ST, Burlington, WI 53105

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Secondary Practice Location 1

Location 11311 S Lincoln StElkhorn, WI 53121-4375 · Phone (262) 723-4600 · Fax (262) 947-4996

Other Identifiers 1

Medicaid100057672WI

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, CareSource (Common Ground Healthcare), HealthPartners and more.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

Nathan R Mathews Md 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 ID143500926

PECOS Enrollment IDI20190718002686

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 19

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 complete exam of visual system 92014

An established patient complete exam of the visual system involves a thorough check of your eyes and vision. It assesses eye health, checks for diseases, and measures your ability to see clearly at different distances. It's a routine, non-invasive procedure.

521 services408 patients

Injection of drug into eye 67028

An injection into the eye is a procedure where a medication is delivered directly into your eye to treat various conditions. A local anesthetic is applied to numb the eye, ensuring minimal discomfort. The drug helps manage diseases like macular degeneration or diabetic retinopathy.

303 services56 patients

Imaging of retina 92134

Imaging of the retina is a non-invasive procedure that captures detailed images of your eye's interior. This helps detect conditions like macular degeneration or retinal detachment. It's painless and takes only a few minutes.

302 services166 patients

Injection, bevacizumab, 10 mg J9035

Bevacizumab is a medication given through an injection. It's designed to prevent the growth of new blood vessels that cancer cells need to grow and spread. The 10 mg dose refers to the amount of the drug in the injection.

280 services49 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.

255 services201 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.

198 services154 patients

Measurement of corneal curvature and depth of eye 92136

This procedure measures the shape and depth of your eye, specifically the cornea, the clear front surface. It helps in diagnosing conditions, planning for surgeries, or fitting contact lenses. It's non-invasive and painless.

159 services106 patients

Removal of cataract with insertion of prosthetic lens 66984

This is a procedure where a cloudy lens in your eye, known as a cataract, is removed. After removal, a clear artificial lens is inserted. This helps to restore your vision, enabling you to see clearly again.

140 services88 patients

Imaging of optic nerve 92133

Imaging of the optic nerve is a non-invasive procedure that captures detailed pictures of your optic nerve. It helps doctors assess eye health, particularly for conditions like glaucoma. It's painless, quick, and uses safe technology like MRI or OCT (Optical Coherence Tomography).

125 services123 patients

New patient complete exam of visual system 92004

A new patient complete exam of the visual system is a thorough evaluation of your eyes and vision. It checks for any potential issues and assesses overall eye health. It includes tests for visual acuity, eye movement, and light response.

102 services102 patients

Exam of visual field with extended testing 92083

An extended visual field exam is a detailed test to evaluate your peripheral (side) vision. It helps to detect any potential blind spots which may not be noticeable in daily life. These could be caused by eye diseases like glaucoma, or neurological conditions.

88 services83 patients

Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more 99212

This is a routine check-up for patients who have previously seen the doctor. During this 10-19 minute visit, the doctor will review your health status, discuss any concerns, and manage ongoing treatments or medications. It's a chance to ensure your health is on track.

44 services41 patients

Extended exam of the back part of the eye with retinal drawing 92201

This procedure involves a detailed examination of the back part of your eye, including the retina. It helps identify any abnormalities or issues. A retinal drawing is made to record findings. It's non-invasive and crucial for maintaining eye health.

43 services27 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.

43 services43 patients

Laser repair to improve eye fluid flow 65855

Laser repair to improve eye fluid flow is a procedure aimed at treating glaucoma. A laser is used to create a small hole in the eye's drainage system, allowing fluid to flow out more easily. This helps to lower the pressure inside the eye, reducing the risk of vision loss.

37 services21 patients

Removal of recurring cataract in lens capsule using a laser 66821

This procedure, known as YAG laser capsulotomy, treats cloudiness in the lens capsule following cataract surgery. A laser is used to create a small hole in the cloudy capsule, allowing light to pass through and restore clear vision. It's a quick, painless procedure.

37 services28 patients

Established patient problem focused exam of visual system 92012

This is a routine check-up for existing patients focusing on the visual system. It involves examining your eyes to detect any potential issues or changes in your vision. It's a crucial part of maintaining good eye health.

37 services35 patients

Exam of the internal drainage system of eye 92020

This is a procedure where your doctor examines the eye's internal drainage system, essential for maintaining eye pressure. They use specialized tools to check for blockages or damage that might lead to conditions like glaucoma. It's non-invasive and painless.

35 services29 patients

Ultrasound scan of cornea to determine thickness 76514

An ultrasound scan of the cornea is a non-invasive procedure that uses sound waves to measure the thickness of your cornea. This helps in diagnosing certain eye conditions and planning treatments. No discomfort or pain is typically experienced.

24 services24 patients

Hospital Affiliations CMS Care Compare

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

Aurora Memorial Hospital Burlington

Acute Care Hospitals · Burlington, WI

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number520059

Location252 Mchenry StBurlington, WI 53105 · Racine County

Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 53105 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

$123.69 typical visit price

range $53.90 – $163.24

Typical copayment $30.92 (range $13.47 – $40.81)

Most-billed visit code 99204

Established Patient

$67.37 typical visit price

range $17.40 – $133.76

Typical copayment $16.84 (range $4.35 – $33.44)

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.

70.27/100

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

Individually scored

Quality

66.55

Promoting Interoperability

Improvement Activities

Cost

36.03

Reported Quality Measures

Age-Related Macular Degeneration (AMD): Dilated Macular Examination

97%312 patients4/55-star benchmark: 100%

Closing the Referral Loop: Receipt of Specialist Report

84%69 patients4/55-star benchmark: 100%

Documentation of Current Medications in the Medical Record

26%3,907 patients1/55-star benchmark: 100%

Primary Open-Angle Glaucoma (POAG): Reduction of Intraocular Pressure (IOP) by 15% OR Documentation of a Plan of Care

94%235 patients

Provide Patients Electronic Access to Their Health Information

97%1,094 patients4/55-star benchmark: 100%

Tobacco Use and Help with Quitting Among Adolescents

73%48 patients1/55-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.

Frames, purchases V2020

Other-Vision, Hearing, and Speech Services · category OC000N

3 suppliers12 claims12 services$57.41 avg. paid by Medicare

Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

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Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

EYE PHYSICIANS & SURGEONS SC

Ophthalmology

675 W STATE ST
BURLINGTON, WI 53105

Racine County (262) 763-7772

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 Nathan Mathews's NPI number?

The NPI number for Nathan Mathews is 1275928624. It was assigned to this individual provider in the NPPES registry on April 2, 2015.

Where is Nathan Mathews located?

Nathan Mathews practices at 675 W State St, Burlington, WI 53105. The listed phone number is (262) 763-7613.

What is Nathan Mathews's specialty?

The primary specialty registered for this NPI is Ophthalmology with taxonomy code 207W00000X.

Is Nathan Mathews enrolled in Medicare?

Yes. Nathan Mathews 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 Nathan Mathews accept?

Health plans from Anthem Blue Cross and Blue Shield, CareSource (Common Ground Healthcare), HealthPartners, Quartz and UnitedHealthcare list Nathan Mathews 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 Nathan Mathews affiliated with any hospitals?

According to CMS data, Nathan Mathews is affiliated with Aurora Memorial Hospital Burlington.

When was this NPI record last updated?

The NPPES record for Nathan Mathews was last updated on August 18, 2023. NPI Profile syncs with the weekly NPPES data releases published by CMS.