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MATTHEW DAVID BURSTEIN MD, PHD
NPI 1386031839
Surgery in Buffalo, NY

Active since April 22, 2015PECOS EnrolledAccepts Medicare Assignment
90.9/100
CMS Quality Rating
100 HIGH ST OFC C377, BUFFALO, NY 14203(716) 859-1168 Get Directions Write a Review

NPPES record last updated: January 6, 2021. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Matthew David Burstein Md, Phd NPPES

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

MATTHEW DAVID BURSTEIN MD, PHD (NPI 1386031839) is an individual surgery provider in Buffalo, New York, licensed in New York (303574) and active in the NPI registry since April 2015. He is enrolled in Medicare PECOS, is affiliated with Parma Community General Hospital, and is a graduate of Baylor College Of Medicine (2014).

NPPES Registry Identity

NPI1386031839
Entity TypeIndividualMale
Primary Taxonomy208600000X
Provider Legal NameMATTHEW DAVID BURSTEINCredential: MD, PHD
Location Address100 HIGH ST OFC C377Buffalo, NY 14203-1154
Mailing Address540 Delaware Ave Apt 3gBuffalo, NY 14202-1331 · (954) 461-7413
Phone(716) 859-1168
Sole ProprietorYes
Medical School CMSBaylor College Of MedicineGraduated 2014
Enumeration DateApril 22, 2015
Last NPPES UpdateJanuary 6, 2021
NPPES CertifiedJanuary 6, 2021
✔ NPI 1386031839 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySurgeryAllopathic & Osteopathic Physicians
Taxonomy Code208600000X
Licenses✔ Licensed in NY · 303574✔ Licensed in OH · 57026303
Definition
A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery.
100 HIGH ST OFC C377, Buffalo, NY 14203
Open in Google Maps ↗

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter from Meridian, Ambetter Health 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

Matthew David Burstein Md, Phd 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 ID648563858
PECOS Enrollment IDI20210820000780
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

3

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

Kaleida Health
Same address
General Acute Care Hospital
100 HIGH ST
Buffalo, NY 14203
  • Reassigned Medicare billing, New York enrollment
  • 676 clinicians in this Medicare group
NPI 1366473183 (716) 859-1993
University At Buffalo Surgeons Inc
2.6 mi
Surgery
462 GRIDER ST, DK MILLER BLDG
Buffalo, NY 14215
  • Reassigned Medicare billing, New York enrollment
  • 59 clinicians in this Medicare group
NPI 1508898305 (716) 898-5186
University Primary Care Practices Inc
110 mi
Family Medicine
167F W MAIN RD
Conneaut, OH 44030
  • Reassigned Medicare billing, Ohio enrollment
  • 1,437 clinicians in this Medicare group
NPI 1679602882 (330) 599-7466

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 6

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.

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.
22 services22 patients
Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes 99222
Initial hospital inpatient care is a service where a healthcare provider spends about 50 minutes per day overseeing your care while you're admitted in the hospital. This includes reviewing your health status, planning your treatment, and ensuring your safety and comfort.
22 services21 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.
21 services18 patients
Initial hospital care with straightforward or low level of medical decision making, per day, if using time, at least 40 minutes 99221
Initial hospital inpatient care refers to the first day of your stay in the hospital. This service typically includes a 30-minute check-up with a healthcare professional. They'll assess your health, discuss your condition, and plan your treatment. It's part of ensuring you receive the best possible care.
19 services19 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.
15 services15 patients
Biopsy of large bowel using a flexible endoscope 45380
A biopsy of the large bowel using a flexible endoscope is a procedure where a thin, flexible tube with a camera is inserted through the rectum to examine the bowel. If abnormal tissue is found, a small sample is taken for further examination. This helps in diagnosing conditions like inflammation, polyps, or cancer.
12 services12 patients

Hospital Affiliations CMS Care Compare 3

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

Parma Community General Hospital

Acute Care Hospitals · Parma, OH
5/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number360041
Location7007 Powers BoulevardParma, OH 44129 · Cuyahoga County

Uh St John Medical Center

Acute Care Hospitals · Westlake, OH
5/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number360123
Location29000 Center Ridge RoadWestlake, OH 44145 · Cuyahoga County
Emergency services

Uh Cleveland Medical Center

Acute Care Hospitals · Cleveland, OH
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number360137
Location11100 Euclid AvenueCleveland, OH 44106 · Cuyahoga County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 14203 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
$84.93 typical visit price
range $54.87 – $166.88
Typical copayment $21.23 (range $13.71 – $41.72)
Most-billed visit code 99203
Established Patient
$68.57 typical visit price
range $17.54 – $136.14
Typical copayment $17.14 (range $4.38 – $34.03)
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.

90.9/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored through an Alternative Payment Model
Quality81.8
Promoting Interoperability100
Improvement Activities40

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 Matthew Burstein's NPI number?

The NPI number for Matthew Burstein is 1386031839. It was assigned to this individual provider in the NPPES registry on April 22, 2015.

Where is Matthew Burstein located?

Matthew Burstein practices at 100 High St Ofc C377, Buffalo, NY 14203. The listed phone number is (716) 859-1168.

What is Matthew Burstein's specialty?

The primary specialty registered for this NPI is Surgery with taxonomy code 208600000X.

Is Matthew Burstein enrolled in Medicare?

Yes. Matthew Burstein 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 Matthew Burstein's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Matthew Burstein reassigns Medicare benefits to 3 organizations: Kaleida Health (Buffalo, NY), University At Buffalo Surgeons Inc (Buffalo, NY) and University Primary Care Practices Inc (Conneaut, OH). 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 Matthew Burstein's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Matthew Burstein accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Meridian, Anthem Blue Cross and Blue Shield and Antidote Health Plan of Ohio, Inc. and 2 other insurers list Matthew Burstein 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 Matthew Burstein affiliated with any hospitals?

According to CMS data, Matthew Burstein is affiliated with Parma Community General Hospital, Uh St John Medical Center and Uh Cleveland Medical Center.

When was this NPI record last updated?

The NPPES record for Matthew Burstein was last updated on January 6, 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.