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DR. KEVIN KUMAR MATHUR M.D.
NPI 1598869216
Otolaryngology in Wooster, OH

Active since September 12, 2006PECOS EnrolledAccepts Medicare Assignment
75/100
CMS Quality Rating
1749 CLEVELAND RD, WOOSTER, OH 44691(330) 264-9699(330) 264-7999 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Dr. Kevin Kumar Mathur M.d. NPPES

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

DR. KEVIN KUMAR MATHUR M.D. (NPI 1598869216) is an individual otolaryngology provider in Wooster, Ohio, licensed in Ohio (35082464M) and active in the NPI registry since September 2006. He is enrolled in Medicare PECOS, is affiliated with Wooster Community Hospital, and is a graduate of University Of Toledo College Of Medicine (1998).

NPPES Registry Identity

NPI1598869216
Entity TypeIndividualMale
Primary Taxonomy207Y00000X
Provider Legal NameDR. KEVIN KUMAR MATHURCredential: M.D.
Location Address1749 CLEVELAND RDWooster, OH 44691-2203
Mailing Address1749 Cleveland RdWooster, OH 44691-2203 · (330) 264-9699 · Fax (330) 264-7999
Phone(330) 264-9699
Fax(330) 264-7999
Sole ProprietorYes
Medical School CMSUniversity Of Toledo College Of MedicineGraduated 1998
Enumeration DateSeptember 12, 2006
Last NPPES UpdateJuly 8, 2007
✔ NPI 1598869216 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOtolaryngologyAllopathic & Osteopathic Physicians
Taxonomy Code207Y00000X
License✔ Licensed in OH · 35082464M
Definition
An otolaryngologist-head and neck surgeon provides comprehensive medical and surgical care for patients with diseases and disorders that affect the ears, nose, throat, the respiratory and upper alimentary systems and related structures of the head and neck. An otolaryngologist diagnoses and provides medical and/or surgical therapy or prevention of diseases, allergies, neoplasms, deformities, disorders and/or injuries of the ears, nose, sinuses, throat, respiratory and upper alimentary systems, face, jaws and the other head and neck systems. Head and neck oncology, facial plastic and reconstructive surgery and the treatment of disorders of hearing and voice are fundamental areas of expertise.
1749 CLEVELAND RD, Wooster, OH 44691
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Other Identifiers 3

Medicare UPINH97984
Medicaid2444840OH
Medicare ID-Type UnspecifiedMA4122141OH

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter from Meridian, Ambetter Health 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. Kevin Kumar Mathur 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 ID9638072283
PECOS Enrollment IDI20040130000198
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 11

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.

Professional service for preparation and provision of 1 or more antigens 95165
This service involves the creation and supply of antigens, substances that stimulate your immune system to fight diseases. These antigens can be used in vaccines or allergy tests to help your body build defenses against specific health threats.
2,370 services51 patients
Professional service for single injection of allergen 95115
A single allergen injection is a procedure where a small amount of a specific allergen is injected into your body. This is done to test your body's reaction to the allergen or to help your immune system become less sensitive to it, reducing allergic symptoms.
663 services24 patients
Professional service for multiple injections of allergen 95117
The professional service for multiple injections of allergens involves administering small doses of specific allergens into your body. This is done to help your immune system become less sensitive to them, reducing your allergic reaction over time. It's a safe, effective way to manage allergies.
618 services26 patients
Test for allergy using allergenic extract 95004
An allergy test with allergenic extract is a diagnostic method to identify substances causing allergic reactions. Small amounts of common allergens are introduced to your body, usually through skin pricks or blood tests. Your body's response helps determine your allergies.
608 services24 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.
482 services315 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.
148 services106 patients

Hospital Affiliations CMS Care Compare 2

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

Wooster Community Hospital

Acute Care Hospitals · Wooster, OH
5/5 CMS rating
OwnershipGovernment - Local
CMS Certification Number360036
Location1761 Beall AvenueWooster, OH 44691 · Wayne County
Emergency services Birthing friendly

Pomerene Hospital

Acute Care Hospitals · Millersburg, OH
OwnershipVoluntary non-profit - Private
CMS Certification Number360148
Location981 Wooster RoadMillersburg, OH 44654 · Holmes County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 44691 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
$126.12 typical visit price
range $54.34 – $166.65
Typical copayment $31.53 (range $13.58 – $41.66)
Most-billed visit code 99204
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.

75/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Individually scored

Reported Quality Measures

Closing the Referral Loop: Receipt of Specialist Report
Percentage of patients with referrals, regardless of age, for which the referring provider receives a report from the provider to whom the patient was referred
86%28 patients4/55-star benchmark: 95%
Documentation of Current Medications in the Medical Record
Percentage of visits for patients aged 18 years and older for which the eligible professional or eligible clinician attests to documenting a list of current medications using all immediate resources available on the date of the encounter.
93%2,348 patients4/55-star benchmark: 100%
e-Prescribing
At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology.
98%1,605 patients4/55-star benchmark: 99%
Health Information Exchange
The MIPS eligible clinician that transitions or refers their patient to another setting of care or health care clinician (1) uses CEHRT to create a summary of care record; and (2) electronically transmits such summary to a receiving health care clinician for…
3%30 patients1/55-star benchmark: 88%
Medication Reconciliation
The MIPS eligible clinician performs medication reconciliation for at least one transition of care in which the patient is transitioned into the care of the MIPS eligible clinician.
94%313 patients3/55-star benchmark: 100%
Patient-Specific Education
The MIPS eligible clinician must use clinically relevant information from CEHRT to identify patient-specific educational resources and provide access to those materials to at least one unique patient seen by the MIPS eligible clinician.
16%2,587 patients1/55-star benchmark: 97%
Pneumococcal Vaccination Status for Older Adults
Percentage of patients 65 years of age and older who have ever received a pneumococcal vaccine
1%695 patients1/55-star benchmark: 90%
Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan
Percentage of patients aged 18 years and older with a BMI documented during the current encounter or during the previous twelve months AND with a BMI outside of normal parameters, a follow-up plan is documented during the encounter or during the previous…
86%1,763 patients4/55-star benchmark: 97%
Preventive Care and Screening: Influenza Immunization
Percentage of patients aged 6 months and older seen for a visit between October 1 and March 31 who received an influenza immunization OR who reported previous receipt of an influenza immunization
0%784 patients1/55-star benchmark: 88%
Provide Patient Access
At least one patient seen by the MIPS eligible clinician during the performance period is provided timely access to view online, download, and transmit to a third party their health information subject to the MIPS eligible clinician's discretion to withhold…
72%2,587 patients3/55-star benchmark: 100%
View, Download, or Transmit (VDT)
At least one patient seen by the MIPS eligible clinician during the performance period (or patient-authorized representative) views, downloads or transmits their health information to a third party during the performance period.
1%2,587 patients
Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Referred Medical Equipment & Supplies CMS DME claims 2

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

Budesonide, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose form, up to 0.5 mg J7626
DME-Drugs Administered Through DME · category DG000N
2 suppliers28 claims1,680 services$0.78 avg. paid by Medicare
Pharmacy dispensing fee for inhalation drug(s); per 30 days Q0513
DME-Other DME · category DE000N
2 suppliers27 claims27 services$25.06 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 14

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

CLINICAL STRATEGIES INC
Respiratory Therapist, Registered (Pulmonary Diagnostics)
1749 CLEVELAND RD
WOOSTER, OH 44691
Wayne County (330) 416-0307
DR. JAMES ROBERT HESSLER M.D.
Otolaryngology (Otolaryngology/Facial Plastic Surgery)
1749 CLEVELAND RD
WOOSTER, OH 44691
Wayne County (330) 264-9699
LAUREL WILSON AUD
Audiologist
1749 CLEVELAND RD
WOOSTER, OH 44691
Wayne County (330) 264-9699
DR. ARUN KUMAR MATHUR M.D.
Otolaryngology (Otolaryngology/Facial Plastic Surgery)
1749 CLEVELAND RD
WOOSTER, OH 44691
Wayne County (330) 264-9699
WOOSTER ENT ASSOCIATES INC
Otolaryngology
1749 CLEVELAND RD
WOOSTER, OH 44691
Wayne County (330) 264-9699
CHRISTOPHER T WARTMANN MD
Otolaryngology
1749 CLEVELAND RD
WOOSTER, OH 44691
Wayne County (330) 264-9699
WOOSTER ENT ASSOC
Audiologist-Hearing Aid Fitter
1749 CLEVELAND RD, WOOSTER ENT
WOOSTER, OH 44691
Wayne County (330) 264-9699
WOOSTER EAR NOSE AND THROAT
Audiologist-Hearing Aid Fitter
1749 CLEVELAND RD
WOOSTER, OH 44691
Wayne County (330) 264-9699

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 Kevin Mathur's NPI number?

The NPI number for Kevin Mathur is 1598869216. It was assigned to this individual provider in the NPPES registry on September 12, 2006.

Where is Kevin Mathur located?

Kevin Mathur practices at 1749 Cleveland Rd, Wooster, OH 44691. The listed phone number is (330) 264-9699.

What is Kevin Mathur's specialty?

The primary specialty registered for this NPI is Otolaryngology with taxonomy code 207Y00000X.

Is Kevin Mathur enrolled in Medicare?

Yes. Kevin Mathur 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 Kevin Mathur accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Meridian, CareSource and MedMutual and 1 other insurer list Kevin Mathur 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 Kevin Mathur affiliated with any hospitals?

According to CMS data, Kevin Mathur is affiliated with Wooster Community Hospital and Pomerene Hospital.

When was this NPI record last updated?

The NPPES record for Kevin Mathur was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 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.