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DR. MATHEW BRYAN MERGENTHALER O.D.
NPI 1568874907
Optometrist in Medford, WI

Active since May 20, 2014PECOS EnrolledAccepts Medicare Assignment
94.31/100
CMS Quality Rating
671 S GIBSON ST, MEDFORD, WI 54451(608) 790-5851 Get Directions Write a Review

NPPES record last updated: January 7, 2026. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Jan 7, 2026, Oct 9, 2024, May 9, 2019 and 1 more (4 updates tracked since 2018).

About Dr. Mathew Bryan Mergenthaler O.d. NPPES

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

DR. MATHEW BRYAN MERGENTHALER O.D. (NPI 1568874907) is an individual optometrist in Medford, Wisconsin, licensed in Wisconsin (3359) and active in the NPI registry since May 2014. He is enrolled in Medicare PECOS and is a graduate of Illinois College Of Optometry At Chicago (2014).

NPPES Registry Identity

NPI1568874907
Entity TypeIndividualMale
Primary Taxonomy152W00000X
Provider Legal NameDR. MATHEW BRYAN MERGENTHALERCredential: O.D.
Location Address671 S GIBSON STMedford, WI 54451-1631
Mailing Address671 S Gibson StMedford, WI 54451-1631 · (608) 790-5851 · Fax (715) 748-4565
Phone(608) 790-5851
Sole ProprietorNo
Medical School CMSIllinois College Of Optometry At ChicagoGraduated 2014
Enumeration DateMay 20, 2014
Last NPPES UpdateJanuary 7, 20264 updates tracked since enumeration
NPPES CertifiedJanuary 7, 2026
✔ NPI 1568874907 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOptometristEye and Vision Services Providers
Taxonomy Code152W00000X
Licenses✔ Licensed in WI · 3359✔ Licensed in IA · 073539
Definition
Doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system.
671 S GIBSON ST, Medford, WI 54451
Open in Google Maps ↗

Other Identifiers 1

Medicaid100039841WI

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, Aspirus Health Plan, Blue Cross and Blue Shield of Louisiana 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. Mathew Bryan Mergenthaler O.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 ID8921226879
PECOS Enrollment IDI20140905001952, I20260126001556
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

3

Medicare enrollment records show Mathew Mergenthaler reassigns Medicare billing to 3 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Healthview Eye Care Center-Medford Sc
1.4 mi
Optometrist
353 N 8TH ST
Medford, WI 54451
  • Reassigned Medicare billing, Wisconsin enrollment
  • 8 clinicians in this Medicare group
NPI 1164492872 (715) 748-2020
Healthview Eye Care Centers, Sc
15 mi
Optometrist
120 DEHNE DR
Colby, WI 54421
  • Reassigned Medicare billing, Wisconsin enrollment
  • Medicare enrollment name: Healthview Eye Care Center, Sc
  • 7 clinicians in this Medicare group
NPI 1588634208 (715) 223-4003
Shoptikal LLC
33 mi
Eyewear Supplier
728 E 2ND ST
Merrill, WI 54452
  • Reassigned Medicare billing, Wisconsin and Minnesota enrollments
  • Also billed through NPI 1730745100 (Minnesota)
  • 187 clinicians in this Medicare group
NPI 1073245700 (715) 536-4292

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 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.

Removal of cataract with insertion of prosthetic lens 66984
This is a procedure where a cloudy lens in your eye, known as a cataract, is removed. After removal, a clear artificial lens is inserted. This helps to restore your vision, enabling you to see clearly again.
2,227 services19 patients
Established patient complete exam of visual system 92014
An established patient complete exam of the visual system involves a thorough check of your eyes and vision. It assesses eye health, checks for diseases, and measures your ability to see clearly at different distances. It's a routine, non-invasive procedure.
171 services171 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.
66 services54 patients
Imaging of optic nerve 92133
Imaging of the optic nerve is a non-invasive procedure that captures detailed pictures of your optic nerve. It helps doctors assess eye health, particularly for conditions like glaucoma. It's painless, quick, and uses safe technology like MRI or OCT (Optical Coherence Tomography).
43 services38 patients
Photography of the retina 92250
Photography of the retina, also known as retinal imaging, is a non-invasive procedure that captures images of the back of your eye. This helps doctors identify and monitor conditions like glaucoma, macular degeneration, or diabetic retinopathy. It's painless and quick, often part of a routine eye exam.
40 services38 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.
25 services23 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 54451 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
$123.69 typical visit price
range $53.90 – $163.24
Typical copayment $30.92 (range $13.47 – $40.81)
Most-billed visit code 99204
Established Patient
$67.37 typical visit price
range $17.40 – $133.76
Typical copayment $16.84 (range $4.35 – $33.44)
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.

94.31/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality88.63
Improvement Activities40

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 Mergenthaler's NPI number?

The NPI number for Mathew Mergenthaler is 1568874907. It was assigned to this individual provider in the NPPES registry on May 20, 2014.

Where is Mathew Mergenthaler located?

Mathew Mergenthaler practices at 671 S Gibson St, Medford, WI 54451. The listed phone number is (608) 790-5851.

What is Mathew Mergenthaler's specialty?

The primary specialty registered for this NPI is Optometrist with taxonomy code 152W00000X.

Is Mathew Mergenthaler enrolled in Medicare?

Yes. Mathew Mergenthaler 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 Mathew Mergenthaler's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Mathew Mergenthaler reassigns Medicare benefits to 3 organizations: Healthview Eye Care Center-Medford Sc (Medford, WI), Healthview Eye Care Centers, Sc (Colby, WI) and Shoptikal LLC (Merrill, WI). 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 Mathew Mergenthaler's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Mathew Mergenthaler accept?

Health plans from Anthem Blue Cross and Blue Shield, Aspirus Health Plan, Blue Cross Blue Shield of Wyoming, Blue Cross and Blue Shield of Louisiana and Blue Cross and Blue Shield of Montana and 6 other insurers list Mathew Mergenthaler 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.

When was this NPI record last updated?

The NPPES record for Mathew Mergenthaler was last updated on January 7, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 months 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.