MATHEW J COSENZA DO
NPI 1356323000
Otolaryngology in Jackson, OH

Q: What is Mathew Cosenza's NPI number?

The NPI number for Mathew Cosenza is 1356323000. It was assigned to this individual provider in the NPPES registry on November 17, 2005.

Q: What is Mathew Cosenza's specialty?

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

Q: When was this NPI record last updated?

The NPPES record for Mathew Cosenza was last updated on January 21, 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.

Active since November 17, 2005PECOS EnrolledAccepts Medicare Assignment

89.98/100

CMS Quality Rating

280 PATTONSVILLE RD, JACKSON, OH 45640(855) 446-5937(740) 395-8834 Get Directions Write a Review

NPPES record last updated: January 21, 2021. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Jan 21, 2021, Oct 24, 2019, Aug 24, 2016 (3 updates tracked since 2016).

On this page

About Mathew J Cosenza Do NPPES

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

MATHEW J COSENZA DO (NPI 1356323000) is an individual otolaryngology provider in Jackson, Ohio, licensed in Ohio (34006288) and active in the NPI registry since November 2005. He is enrolled in Medicare PECOS, is affiliated with Holzer Medical Center, and is a graduate of University Of New England, College Of Osteo Medicine (1994).

NPPES Registry Identity

NPI1356323000

Entity TypeIndividualMale

Primary Taxonomy207Y00000X

Provider Legal NameMATHEW J COSENZACredential: DO

Location Address280 PATTONSVILLE RDJackson, OH 45640-9452

Mailing Address90 Jackson PikeGallipolis, OH 45631-1560 · (740) 446-5418 · Fax (740) 446-5958

Phone(855) 446-5937

Fax(740) 395-8834

Sole ProprietorNo

Medical School CMSUniversity Of New England, College Of Osteo MedicineGraduated 1994

Enumeration DateNovember 17, 2005

Last NPPES UpdateJanuary 21, 20213 updates tracked since enumeration

NPPES CertifiedJanuary 21, 2021

✔ NPI 1356323000 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyOtolaryngologyAllopathic & Osteopathic Physicians

Taxonomy Code207Y00000X

License✔ Licensed in OH · 34006288

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.

Also ListedOtolaryngology · Facial Plastic SurgeryTaxonomy 207YS0123X · License 34006288 (OH)

280 PATTONSVILLE RD, Jackson, OH 45640

Open in Google Maps ↗

Other Identifiers 5

Other7664166Aetna

Other000000260440OH · Anthem Blue Cross

Other2211949OH · Railroad Medicare

Medicaid2211949OH

Other8949866Cigna

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, Antidote Health Plan of Ohio, Inc., CareSource and more.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

Mathew J Cosenza Do 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 ID3072547744

PECOS Enrollment IDI20080409000169

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 Mathew Cosenza reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Holzer Clinic, LLC

25 mi

Multi-Specialty

100 JACKSON PIKE
Gallipolis, OH 45631

Reassigned Medicare billing, Ohio enrollment
321 clinicians in this Medicare group

NPI 1508817248 (740) 446-5385

Adena Medical Group LLC

30 mi

Family Medicine

272 HOSPITAL RD
Chillicothe, OH 45601

Reassigned Medicare billing, Ohio enrollment
763 clinicians in this Medicare group

NPI 1235468083 (740) 779-7500

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 10

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.

195 services147 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.

135 services106 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.

108 services84 patients

New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203

This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.

69 services69 patients

Diagnostic exam of voice box using a flexible endoscope 31575

This procedure involves a doctor examining your voice box using a flexible endoscope, a thin tube with a light and camera. It's inserted through your nose or mouth to visualize your throat area. It helps detect any abnormalities in your voice box, ensuring optimal vocal health.

50 services45 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

Hospital Affiliations CMS Care Compare 2

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

Holzer Medical Center

Acute Care Hospitals · Gallipolis, OH

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number360054

Location100 Jackson PikeGallipolis, OH 45631 · Gallia County

Emergency services Birthing friendly

Holzer Medical Center Jackson

Critical Access Hospitals · Jackson, OH

OwnershipVoluntary non-profit - Private

CMS Certification Number361320

Location500 Burlington RoadJackson, OH 45640 · Jackson County

Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 45640 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

$126.12 typical visit price

range $54.34 – $166.65

Typical copayment $31.53 (range $13.58 – $41.66)

Most-billed visit code 99204

Established Patient

$68.07 typical visit price

range $17.10 – $135.40

Typical copayment $17.01 (range $4.27 – $33.85)

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.

89.98/100

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

Individually scored

Quality

85.73

Improvement Activities

Reported Quality Measures

Appropriate Treatment for Upper Respiratory Infection (URI)

100%66 patients5/55-star benchmark: 100%

Closing the Referral Loop: Receipt of Specialist Report

42%185 patients2/55-star benchmark: 87%

Colorectal Cancer Screening

53%812 patients3/55-star benchmark: 88%

Controlling High Blood Pressure

78%544 patients4/55-star benchmark: 91%

Coronary Artery Disease (CAD): Beta-Blocker Therapy Prior Myocardial Infarction (MI) or Left Ventricular Systolic Dysfunction (LVEF <= 40%)

94%35 patients4/55-star benchmark: 99%

Diabetes: Hemoglobin A1c (HbA1c) Poor Control (>9%)

Lower rates are better for this measure.

26%218 patients4/55-star benchmark: 91%

Documentation of Current Medications in the Medical Record

98%2,416 patients4/55-star benchmark: 100%

Falls: Screening for Future Fall Risk

59%559 patients3/55-star benchmark: 100%

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

33%1,468 patients2/55-star benchmark: 98%

Preventive Care and Screening: Screening for High Blood Pressure and Follow-Up Documented

9%1,393 patients1/55-star benchmark: 61%

Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention

Patients combinedPopulations: 86% · 1,478 patients

Patients screened: 93% · 1,478 patients

66%302 patients3/55-star benchmark: 100%

Statin Therapy for the Prevention and Treatment of Cardiovascular Disease

75%506 patients3/55-star benchmark: 91%

Use of High-Risk Medications in Older Adults

Lower rates are better for this measure.

Patients appropriateDiagnosis: 1% · 555 patients

Patients totalRate: 20% · 589 patients

22%589 patients2/55-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.

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.

BREANNA MORGAN CNP

Family Medicine