DR. EDWARD JOHN MATHEIS M.D.
NPI 1316952187
Internal Medicine - Critical Care Medicine in Raleigh, NC
About Dr. Edward John Matheis M.d. NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
DR. EDWARD JOHN MATHEIS M.D. (NPI 1316952187) is an individual critical care medicine provider in Raleigh, North Carolina, licensed in North Carolina (38270) and active in the NPI registry since July 2006. He is enrolled in Medicare PECOS and is a graduate of University Of Texas Medical Branch At Galveston (1988).
NPPES Registry Identity
Specialties & Licenses 3
Other Identifiers 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Dr. Edward John Matheis 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.
Medicare Billing Reassignments
6Medicare enrollment records show Edward Matheis reassigns Medicare billing to 6 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Raleigh, NC 27610
- Reassigned Medicare billing, North Carolina enrollment
- 997 clinicians in this Medicare group
Charlotte, NC 28210
- Reassigned Medicare billing, North Carolina enrollment
- 25 clinicians in this Medicare group
Thomaston, GA 30286
- Reassigned Medicare billing, California enrollment
- 19 clinicians in this Medicare group
Opelika, AL 36801
- Reassigned Medicare billing, Alabama, Arkansas, Florida, Indiana, Kentucky, Maine, Missouri, Montana, North Carolina, New Mexico, New York, Ohio, South Carolina, Texas and Virginia enrollments
- Medicare enrollment name: Access Telecare PLLC
- Also billed through NPI 1013303080 (Virginia)
- 149 clinicians in this Medicare group
Dallas, TX 75201
- Reassigned Medicare billing, California enrollment
- Medicare enrollment name: Access Telecare California PC
- 194 clinicians in this Medicare group
Dallas, TX 75201
- Reassigned Medicare billing, Kansas enrollment
- 82 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Areas of Expertise CMS Part B claims 3
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.
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.
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.
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 Edward Matheis's NPI number?
The NPI number for Edward Matheis is 1316952187. It was assigned to this individual provider in the NPPES registry on July 30, 2006.
Where is Edward Matheis located?
Edward Matheis practices at 3000 New Bern Ave, Raleigh, NC 27610. The listed phone number is (919) 232-5202.
What is Edward Matheis's specialty?
The primary specialty registered for this NPI is Internal Medicine, specializing in Critical Care Medicine, with taxonomy code 207RC0200X.
Is Edward Matheis enrolled in Medicare?
Yes. Edward Matheis 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.
Which organizations bill Medicare for Edward Matheis's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Edward Matheis reassigns Medicare benefits to 6 organizations: Wakemed Specialists Group, LLC (Raleigh, NC), Hospitalist Solution, PLLC (Charlotte, NC), Upson Medical Associates LLC (Thomaston, GA), East Alabama Medical Center Pec (Opelika, AL), Access Telecare California, P.C. (Dallas, TX) and 1 more organization, listed in the Medicare section above. Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Edward Matheis's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Edward Matheis accept?
Health plans from Ambetter Health, Ambetter from Absolute Total Care, Ambetter of Alabama, Ambetter of North Carolina and Ambetter of Tennessee and 1 other insurer list Edward Matheis 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.
When was this NPI record last updated?
The NPPES record for Edward Matheis was last updated on March 9, 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.
# Dr. Edward John Matheis, M.D. · NPI 1316952187
Critical Care Medicine physician in Raleigh, North Carolina. Individual provider, active in the CMS NPPES registry since July 30, 2006.
## Identity
- **NPI:** 1316952187 (Entity type: Individual)
- **Enumerated:** July 30, 2006
- **Primary specialty:** Internal Medicine - Critical Care Medicine · taxonomy 207RC0200X
- **State license:** 38270 (North Carolina)
- **Sole proprietor:** No
## Practice location
- **Address:** 3000 NEW BERN AVE, Raleigh, NC 27610-1231
- **Phone:** (919) 232-5202
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** 6 organizations under Medicare reassignment (form CMS-855R): Wakemed Specialists Group, LLC (NPI 1063077436, Raleigh, NC); Hospitalist Solution, PLLC (NPI 1457853079, Charlotte, NC); Upson Medical Associates LLC (NPI 1871575993, Thomaston, GA); East Alabama Medical Center Pec (NPI 1811438054, Opelika, AL); Access Telecare California, P.C. (NPI 1861959959, Dallas, TX); and 1 more · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** University Of Texas Medical Branch At Galveston, class of 1988
## Record status
- **NPPES last updated:** March 9, 2021
- **Other identifiers:** Medicaid 8954893 (NC)
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Source: [NPI Profile](https://npiprofile.com/npi/1316952187) · Data from the CMS NPPES public registry.