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DR. KELLI DAWN MATHEW D.O.
NPI 1386962223
Internal Medicine - Pulmonary Disease in Lexington, KY

Active since May 15, 2010PECOS EnrolledAccepts Medicare Assignment
82.82/100
CMS Quality Rating
800 ROSE ST, LEXINGTON, KY 40536(859) 218-0837(859) 257-2605 Get Directions Write a Review

NPPES record last updated: January 7, 2021. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Dr. Kelli Dawn Mathew D.o. NPPES

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

DR. KELLI DAWN MATHEW D.O. (NPI 1386962223) is an individual pulmonary disease provider in Lexington, Kentucky, licensed in Kentucky (03587) and active in the NPI registry since May 2010. She is enrolled in Medicare PECOS, is affiliated with St Claire Regional Medical Center, and is a graduate of Other (2010).

NPPES Registry Identity

NPI1386962223
Entity TypeIndividualFemale
Primary Taxonomy207RP1001X
Provider Legal NameDR. KELLI DAWN MATHEWCredential: D.O.
Location Address800 ROSE STLexington, KY 40536-0001
Mailing Address800 Rose StLexington, KY 40536-0001
Phone(859) 218-0837
Fax(859) 257-2605
Sole ProprietorNo
Medical School CMSOtherGraduated 2010
Enumeration DateMay 15, 2010
Last NPPES UpdateJanuary 7, 2021
NPPES CertifiedJanuary 7, 2021
✔ NPI 1386962223 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyInternal Medicine · Pulmonary DiseaseAllopathic & Osteopathic Physicians
Taxonomy Code207RP1001X
License✔ Licensed in KY · 03587
Definition
An internist who treats diseases of the lungs and airways. The pulmonologist diagnoses and treats cancer, pneumonia, pleurisy, asthma, occupational and environmental diseases, bronchitis, sleep disorders, emphysema and other complex disorders of the lungs.
Also ListedInternal MedicineTaxonomy 207R00000X · License 03587 (KY)
800 ROSE ST, Lexington, KY 40536
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

Dr. Kelli Dawn Mathew D.o. 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 ID941441240
PECOS Enrollment IDI20130730000187
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

6

Medicare enrollment records show Kelli Mathew reassigns Medicare billing to 6 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

St. Claire Medical Center, Inc
41 mi
Rural Health
632 SLATE AVE
Owingsville, KY 40360
  • Reassigned Medicare billing, Kentucky enrollment
  • 296 clinicians in this Medicare group
NPI 1134180920 (606) 674-6386
Community Medical Associates, Inc.
61 mi
Multi-Specialty
4803 OLYMPIA PARK PLZ STE 1100
Louisville, KY 40241
  • Reassigned Medicare billing, Kentucky enrollment
  • 1,896 clinicians in this Medicare group
NPI 1073089850 (502) 588-9490
Baptist Health Medical Group Inc
76 mi
Internal Medicine
2413 RING RD STE 100
Elizabethtown, KY 42701
  • Reassigned Medicare billing, Kentucky enrollment
  • 967 clinicians in this Medicare group
NPI 1093338527 (270) 737-0077
Deaconess Hospital, Inc.
160 mi
Clinical Nurse Specialist
4219 GATEWAY BLVD
Newburgh, IN 47630
  • Reassigned Medicare billing, Indiana enrollment
  • 717 clinicians in this Medicare group
NPI 1619755329 (812) 450-7700
Methodist Health, Inc.
168 mi
Surgery
1413 N ELM ST, SUITE 204
Henderson, KY 42420
  • Reassigned Medicare billing, Indiana and Kentucky enrollments
  • Also billed through NPI 1255933305 (Kentucky)
NPI 1245547892 (270) 830-9973
Waukegan Clinic Corp
348 mi
Family Medicine
1324 N SHERIDAN RD
Waukegan, IL 60085
  • Reassigned Medicare billing, Illinois enrollment
  • 166 clinicians in this Medicare group
NPI 1306937289 (847) 360-3000

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 8

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.

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232
Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.
147 services76 patients
Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes 99233
Follow-up hospital inpatient care per day typically involves a 35-minute check-up by your healthcare provider. This service includes monitoring your health progress, adjusting your treatment plan if needed, and answering any questions you may have about your condition or care.
143 services84 patients
Critical care, first 30-74 minutes 99291
Critical care involves immediate and constant attention by a team of specially-trained health professionals. It's for patients with life-threatening conditions, requiring first 30-74 minutes of intense monitoring and treatment.
121 services57 patients
Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes 99223
Initial hospital inpatient care per day, typically 70 minutes, refers to the daily medical service provided to patients admitted to the hospital. This includes a comprehensive evaluation, diagnosis, treatment plan, and monitoring of your health condition. It ensures your well-being during your hospital stay.
51 services51 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.
20 services20 patients
Insertion of non-tunneled central venous tube for infusion (5 years or older) 36556
This procedure involves placing a thin tube into a large vein, usually in the neck or chest, to administer medication or fluids. It's done under local anesthesia to minimize discomfort. It's a standard, safe procedure for individuals aged 5 and above.
15 services15 patients

Hospital Affiliations CMS Care Compare 3

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

St Claire Regional Medical Center

Acute Care Hospitals · Morehead, KY
3/5 CMS rating
OwnershipGovernment - Federal
CMS Certification Number180018
Location222 Medical CircleMorehead, KY 40351 · Rowan County
Emergency services Birthing friendly

University Of Kentucky Hospital

Acute Care Hospitals · Lexington, KY
3/5 CMS rating
OwnershipGovernment - State
CMS Certification Number180067
Location800 Rose StreetLexington, KY 40536 · Fayette County
Emergency services Birthing friendly

Norton Hospitals, Inc

Acute Care Hospitals · Louisville, KY
2/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number180088
Location200 East Chestnut StreetLouisville, KY 40202 · Jefferson County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 40536 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
$122.77 typical visit price
range $52.76 – $162.27
Typical copayment $30.69 (range $13.19 – $40.56)
Most-billed visit code 99204
Established Patient
$93.94 typical visit price
range $16.53 – $131.99
Typical copayment $23.48 (range $4.13 – $32.99)
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.

82.82/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality83.28
Promoting Interoperability100
Improvement Activities40
Cost45.24

Referred Medical Equipment & Supplies CMS DME claims 8

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

Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing E0431
DME-Oxygen and Supplies · category DC000N
3 suppliers20 claims20 services$15.48 avg. paid by Medicare
Home ventilator, any type, used with non-invasive interface, (e.g., mask, chest shell) E0466
DME-Other DME · category DE005N
6 suppliers102 claims102 services$912.94 avg. paid by Medicare
Nebulizer, with compressor E0570
DME-Other DME · category DE000N
2 suppliers17 claims17 services$6.65 avg. paid by Medicare
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate E1390
DME-Oxygen and Supplies · category DC002N
5 suppliers48 claims48 services$84.42 avg. paid by Medicare
Portable oxygen concentrator, rental E1392
DME-Oxygen and Supplies · category DC002N
1 supplier21 claims21 services$31.41 avg. paid by Medicare
Arformoterol, inhalation solution, fda approved final product, non-compounded, administered through dme, unit dose form, 15 micrograms J7605
DME-Drugs Administered Through DME · category DG006N
2 suppliers13 claims780 services$4.03 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 20

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

DR. JEREMY WAYNE THACKER M.D.
Radiology (Diagnostic Radiology)
800 ROSE ST, HX-302 UKMC
LEXINGTON, KY 40536
Fayette County (859) 257-4457
DR. KIRK PHILLIP HEITMAN M.D.
Pathology (Anatomic Pathology & Clinical Pathology)
800 ROSE ST, MS117
LEXINGTON, KY 40536
Fayette County (859) 257-1446
HARISH RAM MD
Anesthesiology
800 ROSE ST
LEXINGTON, KY 40536
Fayette County (859) 323-5956
MS. YVONNE P RICE APRN NP-C
Nurse Practitioner (Family)
800 ROSE ST
LEXINGTON, KY 40536
Fayette County (859) 218-1779
VANESSA D. SMITH MD
Pathology (Anatomic Pathology)
800 ROSE ST
LEXINGTON, KY 40536
Fayette County (859) 323-6183
JASMINE HOWARD APRN
Nurse Practitioner (Acute Care)
800 ROSE ST, MN604
LEXINGTON, KY 40536
Fayette County (859) 323-6047
MITCHELL ALEXANDER MIGUEL M.D.
Hospitalist
800 ROSE ST
LEXINGTON, KY 40536
Fayette County (859) 323-6047
LEAH RAY YEAGER APRN
Nurse Practitioner (Family)
800 ROSE ST, CC417
LEXINGTON, KY 40536
Fayette County (859) 257-1223

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 Kelli Mathew's NPI number?

The NPI number for Kelli Mathew is 1386962223. It was assigned to this individual provider in the NPPES registry on May 15, 2010.

Where is Kelli Mathew located?

Kelli Mathew practices at 800 Rose St, Lexington, KY 40536. The listed phone number is (859) 218-0837.

What is Kelli Mathew's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Pulmonary Disease, with taxonomy code 207RP1001X.

Is Kelli Mathew enrolled in Medicare?

Yes. Kelli 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.

Which organizations bill Medicare for Kelli Mathew's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Kelli Mathew reassigns Medicare benefits to 6 organizations: St. Claire Medical Center, Inc (Owingsville, KY), Community Medical Associates, Inc. (Louisville, KY), Baptist Health Medical Group Inc (Elizabethtown, KY), Deaconess Hospital, Inc. (Newburgh, IN), Methodist Health, Inc. (Henderson, KY) 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 Kelli Mathew's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Kelli Mathew accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Meridian, Anthem Blue Cross and Blue Shield and CareSource list Kelli 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.

Is Kelli Mathew affiliated with any hospitals?

According to CMS data, Kelli Mathew is affiliated with St Claire Regional Medical Center, University Of Kentucky Hospital and Norton Hospitals, Inc.

When was this NPI record last updated?

The NPPES record for Kelli Mathew was last updated on January 7, 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.