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MATHEW M EDAVETTAL MD
NPI 1467680454
Surgery in Lancaster, PA

Active since June 29, 2009PECOS EnrolledAccepts Medicare Assignment
90.84/100
CMS Quality Rating
555 N DUKE ST, LANCASTER, PA 17602(717) 544-5511 Get Directions Write a Review

NPPES record last updated: June 29, 2009. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Mathew M Edavettal Md NPPES

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

MATHEW M EDAVETTAL MD (NPI 1467680454) is an individual surgery provider in Lancaster, Pennsylvania, licensed in Pennsylvania (MD437555) and active in the NPI registry since June 2009. He is enrolled in Medicare PECOS, is affiliated with Ascension Sacred Heart Bay, and is a graduate of Louisiana State University School Of Medicine In New Orleans (2001).

NPPES Registry Identity

NPI1467680454
Entity TypeIndividualMale
Primary Taxonomy208600000X
Provider Legal NameMATHEW M EDAVETTALCredential: MD
Location Address555 N DUKE STLancaster, PA 17602-2250
Mailing Address555 N Duke StLancaster, PA 17602-2250 · (717) 544-5511
Phone(717) 544-5511
Sole ProprietorNo
Medical School CMSLouisiana State University School Of Medicine In New OrleansGraduated 2001
Enumeration DateJune 29, 2009
✔ NPI 1467680454 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySurgeryAllopathic & Osteopathic Physicians
Taxonomy Code208600000X
License✔ Licensed in PA · MD437555
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.
555 N DUKE ST, Lancaster, PA 17602
Open in Google Maps ↗

Other Identifiers 1

OtherMD437555PA · Pa Medical License

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter Health, Ambetter of Alabama, Florida Blue (BlueCross BlueShield FL) 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

Mathew M Edavettal 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 ID6901943398
PECOS Enrollment IDI20200812001855
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 3

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.

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.
44 services44 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.
44 services43 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.
13 services13 patients

Hospital Affiliations CMS Care Compare 3

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

Ascension Sacred Heart Bay

Acute Care Hospitals · Panama City, FL
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number100026
Location615 N Bonita AvePanama City, FL 32401 · Bay County
Emergency services

Sacred Heart Hospital On The Emerald Coast

Acute Care Hospitals · Miramar Beach, FL
5/5 CMS rating
OwnershipVoluntary non-profit - Other
CMS Certification Number100292
Location7800 Us Hwy 98 WMiramar Beach, FL 32550 · Walton County
Emergency services Birthing friendly

Ascension Sacred Heart Gulf

Acute Care Hospitals · Port Saint Joe, FL
OwnershipVoluntary non-profit - Private
CMS Certification Number100313
Location3801 E Hwy 98Port Saint Joe, FL 32456 · Gulf County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 17602 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
$84.88 typical visit price
range $54.64 – $166.87
Typical copayment $21.22 (range $13.66 – $41.71)
Most-billed visit code 99203
Established Patient
$68.36 typical visit price
range $17.33 – $135.84
Typical copayment $17.09 (range $4.33 – $33.96)
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.

90.84/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored through an Alternative Payment Model
Quality81.68
Promoting Interoperability100
Improvement Activities40

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.

TYLER JOHNSTON MD
Family Medicine
555 N DUKE ST
LANCASTER, PA 17602
Lancaster County (717) 544-5511
LANCASTER GENERAL HOSPITAL
Dietitian, Registered
555 N DUKE ST
LANCASTER, PA 17602
Lancaster County (717) 544-5511
DAVID PETKASH MD
Psychiatry & Neurology (Psychiatry)
555 N DUKE ST
LANCASTER, PA 17602
Lancaster County (717) 544-5511
JACQUELINE N MAST CRNA
Nurse Anesthetist, Certified Registered
555 N DUKE ST
LANCASTER, PA 17602
Lancaster County (717) 544-5511
MS. JULIA DARLENE FULLER C.R.N.A.
Nurse Anesthetist, Certified Registered
555 N DUKE ST
LANCASTER, PA 17602
Lancaster County (717) 544-7890
NANCY L ADAMOPOULOS MD
Internal Medicine
555 N DUKE ST
LANCASTER, PA 17602
Lancaster County (717) 544-8144
LILIA BRICE
Nurse Anesthetist, Certified Registered
555 N DUKE ST
LANCASTER, PA 17602
Lancaster County (717) 544-5511
JEROME BROAD CRNA
Nurse Anesthetist, Certified Registered
555 N DUKE ST
LANCASTER, PA 17602
Lancaster County (717) 544-5511

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 Mathew Edavettal's NPI number?

The NPI number for Mathew Edavettal is 1467680454. It was assigned to this individual provider in the NPPES registry on June 29, 2009.

Where is Mathew Edavettal located?

Mathew Edavettal practices at 555 N Duke St, Lancaster, PA 17602. The listed phone number is (717) 544-5511.

What is Mathew Edavettal's specialty?

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

Is Mathew Edavettal enrolled in Medicare?

Yes. Mathew Edavettal 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 Mathew Edavettal accept?

Health plans from Ambetter Health, Ambetter of Alabama, Florida Blue (BlueCross BlueShield FL), Florida Blue HMO (a BlueCross BlueShield FL company) and Molina Healthcare and 1 other insurer list Mathew Edavettal 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 Mathew Edavettal affiliated with any hospitals?

According to CMS data, Mathew Edavettal is affiliated with Ascension Sacred Heart Bay, Sacred Heart Hospital On The Emerald Coast and Ascension Sacred Heart Gulf.

When was this NPI record last updated?

The NPPES record for Mathew Edavettal was last updated on June 29, 2009. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 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.