1. Home
  2. Directory
  3. Ohio
  4. Lima
  5. Thoracic Surgery Cardiothoracic Vascular Surgery
  6. NPI Profile

MARIO MATOS-CRUZ M.D.
NPI 1588868616
Thoracic Surgery (Cardiothoracic Vascular Surgery) in Lima, OH

Active since June 13, 2007PECOS EnrolledAccepts Medicare Assignment
97.58/100
CMS Quality Rating
830 W HIGH ST STE 207, LIMA, OH 45801(419) 996-4011(419) 996-4012 Get Directions Write a Review

NPPES record last updated: November 5, 2024. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Nov 5, 2024, Dec 9, 2020, Feb 21, 2018 and 2 more (5 updates tracked since 2016).

About Mario Matos-cruz M.d. NPPES

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

MARIO MATOS-CRUZ M.D. (NPI 1588868616) is an individual thoracic surgery (cardiothoracic vascular surgery) provider in Lima, Ohio, licensed in Ohio (35065706) and active in the NPI registry since June 2007. He is enrolled in Medicare PECOS, maintains a secondary practice location in Newark, and is a graduate of University Of Puerto Rico School Of Medicine (1982).

NPPES Registry Identity

NPI1588868616
Entity TypeIndividualMale
Primary Taxonomy208G00000X
Provider Legal NameMARIO MATOS-CRUZCredential: M.D.
Location Address830 W HIGH ST STE 207Lima, OH 45801-3975
Mailing AddressPo Box 432Pikeville, KY 41502-0432 · (606) 218-6402 · Fax (606) 218-7502
Phone(419) 996-4011
Fax(419) 996-4012
Sole ProprietorNo
Medical School CMSUniversity Of Puerto Rico School Of MedicineGraduated 1982
Enumeration DateJune 13, 2007
Last NPPES UpdateNovember 5, 20245 updates tracked since enumeration
NPPES CertifiedNovember 5, 2024
✔ NPI 1588868616 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyThoracic Surgery (Cardiothoracic Vascular Surgery)Allopathic & Osteopathic Physicians
Taxonomy Code208G00000X
Licenses✔ Licensed in OH · 35065706✔ Licensed in DE · C1-0027419
Definition
A thoracic surgeon provides the operative, perioperative and critical care of patients with pathologic conditions within the chest. Included is the surgical care of coronary artery disease, cancers of the lung, esophagus and chest wall, abnormalities of the trachea, abnormalities of the great vessels and heart valves, congenital anomalies, tumors of the mediastinum and diseases of the diaphragm. The management of the airway and injuries of the chest is within the scope of the specialty.
830 W HIGH ST STE 207, Lima, OH 45801
Open in Google Maps ↗

Secondary Practice Location 1

Location 14755 OGLETOWN STANTON ROAD, SUITE 1E20NEWARK, DE 19718-2200 · Phone (302) 733-5700 · Fax (302) 733-5775

Other Identifiers 2

Medicaid20010800AIN
Medicaid0065177OH

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, Antidote Health Plan of Ohio, Inc., Blue Cross and Blue Shield of Texas 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

Mario Matos-cruz 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 ID9931011293
PECOS Enrollment IDI20120706000409, I20251020002795
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

9

Medicare enrollment records show Mario Matos-cruz reassigns Medicare billing to 9 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Ohiohealth Corporation
75 mi
Cardiovascular Disease
3705 OLENTANGY RIVER RD, SUITE 100
Columbus, OH 43214
  • Reassigned Medicare billing, Ohio enrollment
  • 3,314 clinicians in this Medicare group
NPI 1194979526 (614) 262-6772
Adena Medical Group LLC
111 mi
Family Medicine
272 HOSPITAL RD
Chillicothe, OH 45601
  • Reassigned Medicare billing, Ohio enrollment
  • 763 clinicians in this Medicare group
NPI 1235468083 (740) 779-7500
Usa Vein Clinics Of Cleveland LLC
133 mi
Vascular Surgery
3618 W MARKET ST STE 102
Fairlawn, OH 44333
  • Reassigned Medicare billing, Ohio enrollment
  • 5 clinicians in this Medicare group
NPI 1992204077 (330) 237-9880
Usa Vein Clinics Of Pittsburgh LLC
223 mi
Vascular Surgery
300 CHAPEL HARBOR DR STE 102
Pittsburgh, PA 15238
  • Reassigned Medicare billing, Pennsylvania enrollment
  • 7 clinicians in this Medicare group
NPI 1073012142 (412) 356-0110
Central Iowa Hospital Corporation
493 mi
Family Medicine
2720 8TH ST SW
Altoona, IA 50009
  • Reassigned Medicare billing, Iowa enrollment
  • 545 clinicians in this Medicare group
NPI 1902857618 (515) 967-0133
Sanford Medical Center Fargo
763 mi
Occupational Medicine
3838 12TH AVE N
Fargo, ND 58102
  • Reassigned Medicare billing, North Dakota enrollment
  • 1,464 clinicians in this Medicare group
NPI 1952323974 (701) 234-4700
Regional Clinics Of Longview
816 mi
Internal Medicine
709 HOLLYBROOK DR STE 2301
Longview, TX 75605
  • Reassigned Medicare billing, Texas enrollment
  • 92 clinicians in this Medicare group
NPI 1407047863 (903) 757-5804
Sanford Bismarck
930 mi
Multi-Specialty
565 S 7TH ST
Bismarck, ND 58504
  • Reassigned Medicare billing, North Dakota enrollment
  • 779 clinicians in this Medicare group
NPI 1811941172 (701) 323-5550
Providence Health Alliance
968 mi
Specialist
6901 MEDICAL PKWY
Waco, TX 76712
  • Reassigned Medicare billing, Texas enrollment
  • 176 clinicians in this Medicare group
NPI 1932210838 (254) 751-4061

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 45801 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
$166.65 typical visit price
range $54.34 – $166.65
Typical copayment $41.66 (range $13.58 – $41.66)
Most-billed visit code 99205
Established Patient
$68.07 typical visit price
range $17.10 – $135.40
Typical copayment $17.01 (range $4.27 – $33.85)
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.

97.58/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored through an Alternative Payment Model
Quality86.53
Promoting Interoperability100
Improvement Activities40

Other Providers at the Same Location NPPES 7

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

KATHERINE IRENE WARNER DO
Surgery (Vascular Surgery)
830 W HIGH ST STE 207
LIMA, OH 45801
Allen County (419) 226-9182
MIRNAL ANIL CHAUDHARY MD
Surgery (Vascular Surgery)
830 W HIGH ST STE 207
LIMA, OH 45801
Allen County (419) 226-9182
MOHAMMED JUNAID AKBANI M.D.
Surgery (Vascular Surgery)
830 W HIGH ST STE 207
LIMA, OH 45801
Allen County (419) 226-9182
FELECIA JINWALA MD
Surgery (Vascular Surgery)
830 W HIGH ST STE 207
LIMA, OH 45801
Allen County (419) 226-9182
DR. JOHN HOWARD SIRAK M.D.
Thoracic Surgery (Cardiothoracic Vascular Surgery)
830 W HIGH ST STE 207
LIMA, OH 45801
Allen County (419) 996-4011
MEI ZHEN CAO
Surgery
830 W HIGH ST STE 207
LIMA, OH 45801
Allen County (419) 226-9182
ANTHONY DAVON TURNER MD
Surgery (Vascular Surgery)
830 W HIGH ST STE 207
LIMA, OH 45801
Allen County (419) 226-9182

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 Mario Matos-cruz's NPI number?

The NPI number for Mario Matos-cruz is 1588868616. It was assigned to this individual provider in the NPPES registry on June 13, 2007.

Where is Mario Matos-cruz located?

Mario Matos-cruz practices at 830 W High St Ste 207, Lima, OH 45801. The listed phone number is (419) 996-4011.

What is Mario Matos-cruz's specialty?

The primary specialty registered for this NPI is Thoracic Surgery (Cardiothoracic Vascular Surgery) with taxonomy code 208G00000X.

Is Mario Matos-cruz enrolled in Medicare?

Yes. Mario Matos-cruz 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 Mario Matos-cruz's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Mario Matos-cruz reassigns Medicare benefits to 9 organizations: Ohiohealth Corporation (Columbus, OH), Adena Medical Group LLC (Chillicothe, OH), Usa Vein Clinics Of Cleveland LLC (Fairlawn, OH), Usa Vein Clinics Of Pittsburgh LLC (Pittsburgh, PA), Central Iowa Hospital Corporation (Altoona, IA) and 4 more organizations, listed in the Medicare section above. 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 Mario Matos-cruz's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Mario Matos-cruz accept?

Health plans from Anthem Blue Cross and Blue Shield, Antidote Health Plan of Ohio, Inc., Blue Cross and Blue Shield of Texas, CareSource and MedMutual list Mario Matos-cruz 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 Mario Matos-cruz was last updated on November 5, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 23 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.