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MATTHEW MAXIMILIAN O'BRIEN M.D.
NPI 1417996935
Family Medicine in Wilmington, DE

Active since June 06, 2006PECOS EnrolledAccepts Medicare Assignment
1401 FOULK RD, STE 202, WILMINGTON, DE 19803(302) 478-5650(302) 477-0455 Get Directions Write a Review

NPPES record last updated: July 24, 2013. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Matthew Maximilian O'brien M.d. NPPES

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

MATTHEW MAXIMILIAN O'BRIEN M.D. (NPI 1417996935) is an individual family medicine provider in Wilmington, Delaware, licensed in Delaware (C10005808) and active in the NPI registry since June 2006. He is enrolled in Medicare PECOS, is affiliated with Riddle Memorial Hospital, and is a graduate of Jefferson Medical College Of Thomas Jefferson University (1997).

NPPES Registry Identity

NPI1417996935
Entity TypeIndividualMale
Primary Taxonomy207Q00000X
Provider Legal NameMATTHEW MAXIMILIAN O'BRIENCredential: M.D.
Location Address1401 FOULK RD, STE 202Wilmington, DE 19803-2763
Mailing Address1401 Foulk Rd, Ste 202Wilmington, DE 19803-2763 · (302) 478-5650 · Fax (302) 477-0455
Phone(302) 478-5650
Fax(302) 477-0455
Sole ProprietorNo
Medical School CMSJefferson Medical College Of Thomas Jefferson UniversityGraduated 1997
Enumeration DateJune 6, 2006
Last NPPES UpdateJuly 24, 2013
✔ NPI 1417996935 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in DE · C10005808
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
1401 FOULK RD, Wilmington, DE 19803
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Other Identifiers 3

OtherG02363B01DE · Medicare Ptan
Medicare UPINH23524
Medicare ID-Type UnspecifiedG01415

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Highmark Blue Cross Blue Shield Delaware.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

Matthew Maximilian O'brien 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.

PECOS PAC ID5496641292
PECOS Enrollment IDI20040227000185
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 5

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 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.
508 services147 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.
161 services96 patients
Influenza vaccine split virus, preservative free 90662
The Influenza Vaccine Split Virus, preservative-free, is a flu shot to protect against the influenza virus. It is made from parts of inactivated flu viruses and doesn't contain preservatives, reducing potential side effects. It helps your body develop immunity to the flu.
46 services45 patients
Administration of influenza virus vaccine G0008
The administration of the influenza virus vaccine, also known as the flu shot, is a simple procedure to protect against the flu. A healthcare provider injects a small dose of the vaccine into your arm. This stimulates your immune system to produce antibodies, which will help your body fight off the flu if exposed.
46 services45 patients
Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report 93000
An electrocardiogram (ECG) is a non-invasive test that records your heart's electrical activity. Using 12 leads attached to your body, it captures data to help identify heart conditions. A doctor interprets the results and provides a report.
15 services14 patients

Hospital Affiliations CMS Care Compare

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

Riddle Memorial Hospital

Acute Care Hospitals · Media, PA
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number390222
Location1068 West Baltimore PikeMedia, PA 19063 · Delaware County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 19803 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
$88.37 typical visit price
range $57.12 – $173.08
Typical copayment $22.09 (range $14.28 – $43.27)
Most-billed visit code 99203
Established Patient
$100.68 typical visit price
range $18.36 – $141.05
Typical copayment $25.17 (range $4.59 – $35.26)
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
54%972 patients3/55-star benchmark: 85%
Diabetes: Medical Attention for Nephropathy
The percentage of patients 18-75 years of age with diabetes who had a nephropathy screening test or evidence of nephropathy during the measurement period
65%141 patients3/55-star benchmark: 99%
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.
83%4,293 patients3/55-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.
98%2,994 patients4/55-star benchmark: 100%
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.
99%84 patients4/55-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.
99%1,899 patients5/55-star benchmark: 99%
Pneumococcal Vaccination Status for Older Adults
Percentage of patients 65 years of age and older who have ever received a pneumococcal vaccine
60%974 patients3/55-star benchmark: 90%
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…
8%1,876 patients1/55-star benchmark: 97%
Preventive Care and Screening: Influenza Immunization
Percentage of patients aged 6 months and older seen for a visit between October 1 and March 31 who received an influenza immunization OR who reported previous receipt of an influenza immunization
33%1,207 patients2/55-star benchmark: 88%
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% · 1,333 patients
Patients tobacco: 100% · 1,333 patients
36%221 patients2/55-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…
49%1,899 patients2/55-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…
13%1,899 patients1/55-star benchmark: 59%
Use of High-Risk Medications in the Elderly
Percentage of patients 65 years of age and older who were ordered high-risk medications. Two rates are submitted. 1) Percentage of patients who were ordered at least one high-risk medication.
Lower rates are better for this measure.
Patients 2+: 0% · 974 patients
13%974 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.

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.

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253
DME-Other DME · category DE017N
11 suppliers34 claims85 services$5.09 avg. paid by Medicare
Lancets, per box of 100 A4259
DME-Medical/Surgical Supplies · category DA000N
5 suppliers11 claims13 services$0.95 avg. paid by Medicare
Tubing with integrated heating element for use with positive airway pressure device A4604
DME-Other DME · category DE001N
4 suppliers12 claims12 services$30.86 avg. paid by Medicare
Cushion for use on nasal mask interface, replacement only, each A7032
DME-Other DME · category DE001N
4 suppliers11 claims59 services$14.46 avg. paid by Medicare
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap A7034
DME-Other DME · category DE001N
5 suppliers16 claims16 services$45.53 avg. paid by Medicare
Headgear used with positive airway pressure device A7035
DME-Other DME · category DE001N
5 suppliers13 claims13 services$13.73 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.

HEATHER BITTNER-FAGAN MD
Family Medicine
1401 FOULK RD, SUITE 100B
WILMINGTON, DE 19803
New Castle County (302) 477-3300
DEBORAH HOFFMAN NP
Nurse Practitioner (Adult Health)
1401 FOULK RD, SUITE 100B
WILMINGTON, DE 19803
New Castle County (302) 477-3300
MRS. SHEILA MANGAN P.T.
Physical Therapist
1401 FOULK RD
WILMINGTON, DE 19803
New Castle County (302) 477-4305
DAVID M BERCAW MD
Family Medicine
1401 FOULK RD, SUITE 100B
WILMINGTON, DE 19803
New Castle County (302) 477-3300
PAUL M. IMBER D.O.
Otolaryngology
1401 FOULK RD, SUITE 205
WILMINGTON, DE 19803
New Castle County (302) 998-0300
DR. JOSHUA CLARK SAMUELSON D.O.
Family Medicine
1401 FOULK RD
WILMINGTON, DE 19803
New Castle County (302) 477-3300
STEVEN ROBERT ICKES PT
Physical Therapist
1401 FOULK RD, BRANDYWINE PHYSICAL THERAPY PLUS
WILMINGTON, DE 19803
New Castle County (302) 477-4305
LINDSEY SZYMASZEK D.O
Family Medicine
1401 FOULK RD, SUITE 100
WILMINGTON, DE 19803
New Castle County (302) 477-3300

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 O'brien's NPI number?

The NPI number for Matthew O'brien is 1417996935. It was assigned to this individual provider in the NPPES registry on June 6, 2006.

Where is Matthew O'brien located?

Matthew O'brien practices at 1401 Foulk Rd Ste 202, Wilmington, DE 19803. The listed phone number is (302) 478-5650.

What is Matthew O'brien's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Matthew O'brien enrolled in Medicare?

Yes. Matthew O'brien 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 Matthew O'brien accept?

Health plans from Highmark Blue Cross Blue Shield Delaware list Matthew O'brien 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 O'brien affiliated with any hospitals?

According to CMS data, Matthew O'brien is affiliated with Riddle Memorial Hospital.

When was this NPI record last updated?

The NPPES record for Matthew O'brien was last updated on July 24, 2013. NPI Profile syncs with the weekly NPPES data releases published by CMS.