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DR. GINA MARIE MATHEW MD
NPI 1366731358
Internal Medicine - Endocrinology, Diabetes & Metabolism in Mesa, AZ

Active since March 30, 2011PECOS EnrolledAccepts Medicare Assignment
6424 E BROADWAY RD STE 105, MESA, AZ 85206(623) 876-6960 Get Directions Write a Review

NPPES record last updated: April 23, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Apr 23, 2024, Jun 18, 2020, Jan 30, 2020 and 1 more (4 updates tracked since 2017).

About Dr. Gina Marie Mathew Md NPPES

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

DR. GINA MARIE MATHEW MD (NPI 1366731358) is an individual endocrinology, diabetes & metabolism provider in Mesa, Arizona, licensed in Arizona (52289) and active in the NPI registry since March 2011. She is enrolled in Medicare PECOS, maintains a secondary practice location in Phoenix, and is a graduate of University Of Illinois College Of Med (chi/peor/rock/chm-urb) (2011).

NPPES Registry Identity

NPI1366731358
Entity TypeIndividualFemale
Primary Taxonomy207RE0101X
Provider Legal NameDR. GINA MARIE MATHEWCredential: MD
Location Address6424 E BROADWAY RD STE 105Mesa, AZ 85206-1750
Mailing Address1917 S Crismon RdMesa, AZ 85209-6216 · (623) 876-6960 · Fax (623) 285-2624
Phone(623) 876-6960
Sole ProprietorNo
Medical School CMSUniversity Of Illinois College Of Med (chi/peor/rock/chm-urb)Graduated 2011
Enumeration DateMarch 30, 2011
Last NPPES UpdateApril 23, 20244 updates tracked since enumeration
NPPES CertifiedApril 23, 2024
✔ NPI 1366731358 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyInternal Medicine · Endocrinology, Diabetes & MetabolismAllopathic & Osteopathic Physicians
Taxonomy Code207RE0101X
License✔ Licensed in AZ · 52289
Definition
An internist who concentrates on disorders of the internal (endocrine) glands such as the thyroid and adrenal glands. This specialist also deals with disorders such as diabetes, metabolic and nutritional disorders, obesity, pituitary diseases and menstrual and sexual problems.
Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X
6424 E BROADWAY RD STE 105, Mesa, AZ 85206
Open in Google Maps ↗

Secondary Practice Location 1

Location 14375 E Irma LnPhoenix, AZ 85050-4312 · Phone (623) 876-6960

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arizona Complete Health, Blue Cross Blue Shield of Arizona, Imperial Insurance Companies, Inc. 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

Dr. Gina Marie Mathew 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 ID5698085660
PECOS Enrollment IDI20160812001431
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 7

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.

Injection, denosumab, 1 mg J0897
Denosumab is a medication given via injection to strengthen your bones. It works by slowing down the cells that break down bone, improving bone density and reducing the risk of fractures. It's often used for osteoporosis treatment.
1,380 services17 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.
397 services222 patients
Continuous monitoring of blood sugar level in tissue fluid using sensor under skin with interpretation and report 95251
This procedure involves placing a small sensor under your skin to continuously monitor your blood sugar levels in tissue fluid. The data is interpreted and a report is generated to help manage your diabetes more effectively.
119 services51 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.
70 services54 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.
51 services51 patients
Hemoglobin a1c level 83036
Hemoglobin A1c (HbA1c) is a test that measures your average blood sugar level over the past 2-3 months. It's used to monitor how well diabetes is being controlled. High levels may indicate that your diabetes treatment plan needs adjustment.
24 services22 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 85206 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
$127.71 typical visit price
range $55.44 – $168.60
Typical copayment $31.92 (range $13.86 – $42.15)
Most-billed visit code 99204
Established Patient
$98.00 typical visit price
range $17.72 – $137.41
Typical copayment $24.50 (range $4.43 – $34.35)
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.

Reported Quality Measures

Colorectal Cancer Screening
Percentage of adults 50-75 years of age who had appropriate screening for colorectal cancer
37%466 patients2/55-star benchmark: 85%
Diabetes: Eye Exam
Percentage of patients 18-75 years of age with diabetes who had a retinal or dilated eye exam by an eye care professional during the measurement period or a negative retinal exam (no evidence of retinopathy) in the 12 months prior to the measurement period
53%413 patients3/55-star benchmark: 100%
Diabetes: Foot Exam
The percentage of patients 18-75 years of age with diabetes (type 1 and type 2) who received a foot exam (visual inspection and sensory exam with mono filament and a pulse exam) during the measurement year
61%412 patients3/55-star benchmark: 98%
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.
100%1,917 patients5/55-star benchmark: 100%
e-Prescribing
At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology.
96%2,697 patients4/55-star benchmark: 99%
Health Information Exchange
The MIPS eligible clinician that transitions or refers their patient to another setting of care or health care clinician (1) uses CEHRT to create a summary of care record; and (2) electronically transmits such summary to a receiving health care clinician for…
13%401 patients1/55-star benchmark: 88%
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.
100%92 patients5/55-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.
96%921 patients4/55-star benchmark: 97%
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…
98%839 patients5/55-star benchmark: 97%
Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention
Percentage of patients aged 18 years and older who were screened for tobacco use one or more times within 24 months AND who received tobacco cessation intervention if identified as a tobacco user
Patients screenedForUse: 100% · 589 patients
Patients tobacco: 35% · 31 patients
89%589 patients4/55-star benchmark: 98%
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…
76%921 patients4/55-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…
38%921 patients2/55-star benchmark: 89%
View, Download, or Transmit (VDT)
At least one patient seen by the MIPS eligible clinician during the performance period (or patient-authorized representative) views, downloads or transmits their health information to a third party during the performance period.
38%921 patients
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 6

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

Supplies for maintenance of insulin infusion catheter, per week A4224
DME-Other DME · category DE017N
2 suppliers11 claims143 services$18.20 avg. paid by Medicare
Supplies for external insulin infusion pump, syringe type cartridge, sterile, each A4225
DME-Other DME · category DE017N
2 suppliers11 claims345 services$2.36 avg. paid by Medicare
Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253
DME-Other DME · category DE017N
10 suppliers20 claims68 services$6.51 avg. paid by Medicare
Insulin for administration through dme (i.e., insulin pump) per 50 units J1817
Treatment-Injections and Infusions (nononcologic) · category RI000N
7 suppliers13 claims1,340 services$6.68 avg. paid by Medicare
Supply allowance for therapeutic continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service K0553
DME-Other DME · category DE017N
7 suppliers230 claims239 services$183.55 avg. paid by Medicare
Receiver (monitor), dedicated, for use with therapeutic glucose continuous monitor system K0554
DME-Other DME · category DE017N
3 suppliers17 claims17 services$195.51 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 4

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

ANKUR PANCHAL
Internal Medicine (Cardiovascular Disease)
6424 E BROADWAY RD STE 105
MESA, AZ 85206
Maricopa County (480) 733-7500
OJAS BANSAL M.B.B.S.
Internal Medicine (Cardiovascular Disease)
6424 E BROADWAY RD STE 105
MESA, AZ 85206
Maricopa County (480) 733-7500
DR. ARPIT SOTHWAL MD
Internal Medicine (Interventional Cardiology)
6424 E BROADWAY RD STE 105
MESA, AZ 85206
Maricopa County (480) 733-7500
MS. KAREN BJORN PA
Physician Assistant
6424 E BROADWAY RD STE 105
MESA, AZ 85206
Maricopa County (480) 684-6487

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 Gina Mathew's NPI number?

The NPI number for Gina Mathew is 1366731358. It was assigned to this individual provider in the NPPES registry on March 30, 2011.

Where is Gina Mathew located?

Gina Mathew practices at 6424 E Broadway Rd Ste 105, Mesa, AZ 85206. The listed phone number is (623) 876-6960.

What is Gina Mathew's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Endocrinology, Diabetes & Metabolism, with taxonomy code 207RE0101X.

Is Gina Mathew enrolled in Medicare?

Yes. Gina Mathew 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 Gina Mathew accept?

Health plans from Ambetter from Arizona Complete Health, Blue Cross Blue Shield of Arizona, Imperial Insurance Companies, Inc., Oscar Health Plan, Inc. and UnitedHealthcare list Gina Mathew 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 Gina Mathew was last updated on April 23, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.