MR. MATTHEW HENRY PIELECHA PA-C
NPI 1427232792
Physician Assistant in Flagstaff, AZ

NPI Status: Active since December 21, 2007

Contact Information

1515 E CEDAR AVE STE A-3
FLAGSTAFF, AZ
ZIP 86004
Phone: (928) 774-2788
Fax: (928) 774-0123

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  • Individual
  • Male
  • Years of Experience 20
  • Physician Assistant
  • Accepts Insurance
  • Accepts Medicare Approved Payment
  • PECOS Enrolled

About MATTHEW PIELECHA

This page provides the complete NPI Profile along with additional information for Matthew Pielecha, a primary care provider established in Flagstaff, Arizona with a medical specialization in Physician Assistant and more than 20 years of experience. The healthcare provider is registered in the NPI registry with number 1427232792 assigned on December 2007. The practitioner's primary taxonomy code is 363A00000X with license number 3792 (AZ). The provider is registered as an individual and his NPI record was last updated 7 years ago.

NPI
1427232792
Provider Name
MR. MATTHEW HENRY PIELECHA PA-C
Gender
Male
Entity Type
Individual
Location Address
1515 E CEDAR AVE STE A-3 FLAGSTAFF, AZ 86004
Location Phone
(928) 774-2788
Location Fax
(928) 774-0123
Mailing Address
95 SOLDIERS PASS RD STE B SEDONA, AZ 86336
Mailing Phone
(928) 774-2788
Mailing Fax
(928) 774-0123
Medical School Name
OTHER
Graduation Year
2006
Is Sole Proprietor?
No
Enumeration Date
12-21-2007
Last Update Date
07-07-2018
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A primary care provider (PCP) like Matthew Pielecha sees people with common medical problems. The primary care provider might be a doctor, physician assistant, nurse practitioner or clinic that are usually involved in your long-term care. A PCP might provide preventive care, treat common medical conditions, identify urgent medical problems and refer you to specialists when necessary. Primary care is usually provided in an outpatient facility but if you are admitted to a hospital your PCP may assist in your care. The most common medical conditions seen by primary care providers are: hypertension, upper respiratory tract infections, depression or anxiety, back pain, arthritis, dermatitis, diabetes, urinary tract infections, etc

Location Map

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Physician Assistant

Taxonomy Code
363A00000X
Type
Physician Assistants & Advanced Practice Nursing Providers
License No.
3792
License State
AZ
Taxonomy Description
A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

Secondary Taxonomies

The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.

No. Taxonomy Code Type Classification /
Specialization
License No. (State)
1363A00000XPhysician Assistants & Advanced Practice Nursing Providers

Physician Assistant

PA1368 (NV)

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

  • Blue AdvanceHealth Bronze - MaricopaFocus Network - HMO
  • Blue AdvanceHealth Bronze - Neighborhood Network - HMO
  • Blue AdvanceHealth Bronze - PimaFocus Network - HMO
  • Blue AdvanceHealth Gold - MaricopaFocus Network - HMO
  • Blue AdvanceHealth Gold - Neighborhood Network - HMO
  • Blue AdvanceHealth Gold - PimaFocus Network - HMO
  • Blue AdvanceHealth Silver - MaricopaFocus Network - HMO
  • Blue AdvanceHealth Silver - Neighborhood Network - HMO
  • Blue AdvanceHealth Silver - PimaFocus Network - HMO
  • Blue EverydayHealth Gold - MaricopaFocus Network - HMO
  • Blue EverydayHealth Gold - Neighborhood Network - HMO
  • Blue EverydayHealth Gold - PimaFocus Network - HMO
  • Blue EverydayHealth Silver - MaricopaFocus Network - HMO
  • Blue EverydayHealth Silver - Neighborhood Network - HMO
  • Blue EverydayHealth Silver - PimaFocus Network - HMO
  • Blue Portfolio HSA Bronze - MaricopaFocus Network - HMO
  • Blue Portfolio HSA Bronze - Neighborhood Network - HMO
  • Blue Portfolio HSA Bronze - PimaFocus Network - HMO
  • Blue Portfolio HSA Gold - Statewide PPO Network - PPO
  • Blue PPO PremierHealth Silver - Statewide PPO Network - PPO

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Medicare Participation & PECOS Enrollment Status

Matthew Pielecha is registered with Medicare and accepts claims assignment, this means the provider accepts the approved amount for the cost of rendered services as full payment. Participating providers may not charge beneficiaries more than the approved amount for their services. Please keep in mind that beneficiaries still have to pay a coinsurance or copayment amount for a visit or service.

Matthew Pielecha is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.

What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.

  • Is the provider registered in PECOS? Yes

  • PECOS PAC ID: 5395815997

    What is the PECOS Associate Control ID?
    A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.

  • PECOS Enrollment ID: I20080619000559

    What is the Provider Enrollment ID?
    The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.

  • Accepts Medicare Assignment? Yes

    What does it mean "accepts medicare assignment"?
    When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
    A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.

  • Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes

  • Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes

  • Eligible to Order or Refer a Home Health Agency (HHA): Yes

  • Eligible to Order or Refer Power Mobility Devices: Yes

Areas of Expertise

The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.

Automated urinalysis test

An automated urinalysis test is a routine examination that checks your urine for various substances. It can help identify potential health issues such as kidney problems or diabetes. The test uses a machine to analyze a small urine sample, providing quick and accurate results.

This service was performed 81 times for 69 patients

Detection test by immunoassay technique for severe acute respiratory syndrome coronavirus

An immunoassay test for severe acute respiratory syndrome coronavirus is a diagnostic tool. It uses your body's immune response to detect the presence of the virus. It involves taking a sample, usually from your nose or throat, which is then analyzed in a lab for signs of the virus.

This service was performed 73 times for 71 patients

Detection test by immunoassay with direct visual observation for influenza virus

This is a test that identifies the influenza virus in your body. It works by using an immunoassay, a method that detects the presence of the virus through an immune response. The results are directly observable, making it a quick and efficient way to diagnose flu.

This service was performed 129 times for 65 patients

Detection test by immunoassay with direct visual observation for streptococcus, group a (strep)

A detection test by immunoassay for Group A Strep is a quick procedure to identify a bacterial infection in your throat. It involves taking a throat swab and applying it to a test strip, which changes color if Strep bacteria are present.

This service was performed 34 times for 31 patients

Established patient office or other outpatient visit, 20-29 minutes

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.

This service was performed 284 times for 238 patients

Established patient office or other outpatient visit, 30-39 minutes

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.

This service was performed 28 times for 26 patients

Injection of drug or substance under skin or into muscle

This procedure involves administering medication directly under the skin or into a muscle. A small needle is used to inject the drug, allowing it to be absorbed quickly into the bloodstream. It's a common method for delivering a variety of medications.

This service was performed 25 times for 24 patients

Injection, triamcinolone acetonide, not otherwise specified, 10 mg

Triamcinolone acetonide is a medication used to reduce inflammation in the body. It's given as a 10 mg injection for conditions like allergies, arthritis, or skin problems. The injection helps to decrease swelling, redness, and itching.

This service was performed 60 times for 15 patients

New patient office or other outpatient visit, 30-44 minutes

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.

This service was performed 253 times for 253 patients

New patient office or other outpatient visit, 45-59 minutes

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.

This service was performed 30 times for 30 patients

Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report

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.

This service was performed 13 times for 13 patients

Physician Visit Costs



The typical physician office visit costs for Medicare beneficiaries in this area are: $21.47 for a new patient copayment and $17.31 for an established patient copayment.

The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.

For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.

The prices below reflect the costs for new and established patients in the 86004 ZIP code area.

New Patients Visit Costs *

The most utilized procedure code for new patients office visits is 99203

  • Average New Patient Price $85.89
  • Minimum New Patient Price $55.44
  • Maximum New Patient Price $168.6
  • Average New Patient Copayment $21.47
  • Minimum New Patient Copayment $13.86
  • Maximum New Patient Copayment $42.15

Established Patients Visit Costs *

The most utilized procedure code for established patients office visits is 99213

  • Average Established Patient Price $69.24
  • Minimum Established Patient Price $17.72
  • Maximum Established Patient Price $137.41
  • Average Established Patient Copayment $17.31
  • Minimum Established Patient Copayment $4.43
  • Maximum Established Patient Copayment $34.35

* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.

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NPI Validation Check Digit Calculation


The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.

Start with the original NPI number, the last digit is the check digit and is not used in the calculation.
1427232792
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
2447434718
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 4 + 4 + 7 + 4 + 3 + 4 + 7 + 1 + 8 + 24 = 68
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
70 - 68 = 22

The NPI number 1427232792 is valid because the calculated check digit 2 using the Luhn validation algorithm matches the last digit of the original NPI number.

Other Providers at the Same Location


The following 6 providers are registered at the same or nearby location.

SARA M REEVES FNP

Nurse Practitioner

(Family)

1515 E CEDAR AVE STE A-3
FLAGSTAFF, AZ
ZIP 86004

(928) 774-2788

MEREDITH MARIE SMITH NP

Nurse Practitioner

(Family)

1515 E CEDAR AVE STE A-3
FLAGSTAFF, AZ
ZIP 86004

(928) 774-2788

ALLISON KARINE KAVANAGH

Nurse Practitioner

(Family)

1515 E CEDAR AVE STE A-3
FLAGSTAFF, AZ
ZIP 86004

(928) 774-2788

BROCK WILLIAM VENMAN PA-C

Physician Assistant

1515 E CEDAR AVE STE A-3
FLAGSTAFF, AZ
ZIP 86004

(928) 774-2788

EAST FLAGSTAFF FAMILY MEDICINE LLC

Family Medicine

1515 E CEDAR AVE STE A-3
FLAGSTAFF, AZ
ZIP 86004

(928) 774-2788

DWIGHT JONES FNP-C

Nurse Practitioner

(Family)

1515 E CEDAR AVE STE A-3
FLAGSTAFF, AZ
ZIP 86004

(928) 774-2788

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1427232792, enumerated as an "individual" on December 21, 2007.

The provider is located at 1515 E CEDAR AVE STE A-3 FLAGSTAFF, AZ 86004 and the phone number is (928) 774-2788.

Physician Assistant with taxonomy code 363A00000X.

The provider might be accepting Accepts: Blue Cross Blue Shield of Arizona. Please consult your insurance carrier or call the provider to verify.