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DR. ANDREW T MATHEUS MD
NPI 1467460980
Family Medicine in Ashland, WI

Active since August 03, 2006PECOS EnrolledAccepts Medicare Assignment
89.68/100
CMS Quality Rating
1001 MAIN ST W, ASHLAND, WI 54806(715) 682-5601 Get Directions Write a Review

NPPES record last updated: March 7, 2023. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Mar 7, 2023, Oct 17, 2018 (2 updates tracked since 2018).

About Dr. Andrew T Matheus Md NPPES

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

DR. ANDREW T MATHEUS MD (NPI 1467460980) is an individual family medicine provider in Ashland, Wisconsin, licensed in Wisconsin (33091) and active in the NPI registry since August 2006. He is enrolled in Medicare PECOS, is affiliated with Essentia Health St Mary's Medical Center, and is a graduate of University Of Wisconsin School Of Medicine (1989).

NPPES Registry Identity

NPI1467460980
Entity TypeIndividualMale
Primary Taxonomy207Q00000X
Provider Legal NameDR. ANDREW T MATHEUSCredential: MD
Location Address1001 MAIN ST WAshland, WI 54806-1307
Mailing Address1001 Main St WAshland, WI 54806-1366 · (715) 373-5128
Phone(715) 682-5601
Sole ProprietorNo
Medical School CMSUniversity Of Wisconsin School Of MedicineGraduated 1989
Enumeration DateAugust 3, 2006
Last NPPES UpdateMarch 7, 20232 updates tracked since enumeration
✔ NPI 1467460980 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in WI · 33091
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.
1001 MAIN ST W, Ashland, WI 54806
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Other Identifiers 2

Other33091WI · State License
Medicaid31865900WI

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, HealthPartners, Medica 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. Andrew T Matheus 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 ID8123153582
PECOS Enrollment IDI20100324000390
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 10

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 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.
320 services147 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.
268 services136 patients
Insertion of needle into vein for collection of blood sample 36415
This procedure involves inserting a small needle into a vein, typically in your arm, to collect a blood sample. It's a quick and simple process to help diagnose or monitor health conditions. You may feel a small prick, but discomfort is minimal.
217 services132 patients
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439
An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.
101 services101 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.
31 services30 patients
Automated urinalysis test 81003
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.
21 services15 patients

Hospital Affiliations CMS Care Compare 3

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

Essentia Health St Mary's Medical Center

Acute Care Hospitals · Duluth, MN
5/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number240002
Location402 East Second StreetDuluth, MN 55805 · St. Louis County
Emergency services Birthing friendly

St Lukes Hospital

Acute Care Hospitals · Duluth, MN
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number240047
Location915 East 1st StreetDuluth, MN 55805 · St. Louis County
Emergency services Birthing friendly

Tamarack Health Ashland Medical Center

Critical Access Hospitals · Ashland, WI
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number521359
Location1615 Maple LaneAshland, WI 54806 · Ashland County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 54806 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
$82.92 typical visit price
range $53.90 – $163.24
Typical copayment $20.73 (range $13.47 – $40.81)
Most-billed visit code 99203
Established Patient
$95.41 typical visit price
range $17.40 – $133.76
Typical copayment $23.85 (range $4.35 – $33.44)
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.

89.68/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality81.23
Promoting Interoperability100
Improvement Activities40

Referred Medical Equipment & Supplies CMS DME claims 7

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

Ostomy skin barrier, solid 4 x 4 or equivalent, extended wear, without built-in convexity, each A4385
DME-Orthotic Devices · category DF010N
4 suppliers19 claims415 services$4.66 avg. paid by Medicare
Ostomy pouch, drainable; for use on barrier with flange (2 piece system), each A5063
DME-Orthotic Devices · category DF010N
3 suppliers13 claims257 services$2.41 avg. paid by Medicare
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing E0431
DME-Oxygen and Supplies · category DC000N
1 supplier15 claims15 services$18.45 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
3 suppliers28 claims28 services$114.61 avg. paid by Medicare
Portable oxygen concentrator, rental E1392
DME-Oxygen and Supplies · category DC002N
2 suppliers13 claims13 services$38.09 avg. paid by Medicare
Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg J7613
DME-Drugs Administered Through DME · category DG006N
2 suppliers16 claims2,075 services$0.02 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.

MAINSTREET CLINIC SC
Clinic/Center (Primary Care)
1001 MAIN ST W
ASHLAND, WI 54806
Ashland County (715) 682-5601
RYAN J BRANG MD
Family Medicine
1001 MAIN ST W
ASHLAND, WI 54806
Ashland County (715) 682-5601
CARRIE L ALAJOKI DNP, MSN, APNP
Nurse Practitioner (Family)
1001 MAIN ST W
ASHLAND, WI 54806
Ashland County (715) 682-5601
DR. MARY ANN ANDERSON MD
Family Medicine
1001 MAIN ST W
ASHLAND, WI 54806
Ashland County (715) 682-5601

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 Andrew Matheus's NPI number?

The NPI number for Andrew Matheus is 1467460980. It was assigned to this individual provider in the NPPES registry on August 3, 2006.

Where is Andrew Matheus located?

Andrew Matheus practices at 1001 Main St W, Ashland, WI 54806. The listed phone number is (715) 682-5601.

What is Andrew Matheus's specialty?

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

Is Andrew Matheus enrolled in Medicare?

Yes. Andrew Matheus 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 Andrew Matheus accept?

Health plans from Anthem Blue Cross and Blue Shield, HealthPartners, Medica and Security Health Plan list Andrew Matheus 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 Andrew Matheus affiliated with any hospitals?

According to CMS data, Andrew Matheus is affiliated with Essentia Health St Mary's Medical Center, St Lukes Hospital and Tamarack Health Ashland Medical Center.

When was this NPI record last updated?

The NPPES record for Andrew Matheus was last updated on March 7, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.