DR. SUMEET MATHUR MD
NPI 1609864115
Otolaryngology - Plastic Surgery within the Head & Neck in Johnstown, PA

Q: What is Sumeet Mathur's NPI number?

The NPI number for Sumeet Mathur is 1609864115. It was assigned to this individual provider in the NPPES registry on October 10, 2005.

Q: What is Sumeet Mathur's specialty?

The primary specialty registered for this NPI is Otolaryngology, specializing in Plastic Surgery within the Head & Neck, with taxonomy code 207YX0007X.

Q: When was this NPI record last updated?

The NPPES record for Sumeet Mathur was last updated on July 13, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.

Active since October 10, 2005PECOS EnrolledAccepts Medicare Assignment

1450 SCALP AVE, SUITE 9, JOHNSTOWN, PA 15904(814) 266-1185(814) 266-1199 Get Directions Write a Review

NPPES record last updated: July 13, 2026. Verified against the NPPES registry weekly; last sync: October 18, 2026.

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About Dr. Sumeet Mathur Md NPPES

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

DR. SUMEET MATHUR MD (NPI 1609864115) is an individual plastic surgery within the head & neck provider in Johnstown, Pennsylvania, licensed in Pennsylvania (MD064804L) and active in the NPI registry since October 2005. He is enrolled in Medicare PECOS, is affiliated with Indiana Regional Medical Center, and is a graduate of Harvard Medical School (1993).

NPPES Registry Identity

NPI1609864115

Entity TypeIndividualMale

Primary Taxonomy207YX0007X

Provider Legal NameDR. SUMEET MATHURCredential: MD

Location Address1450 SCALP AVE, SUITE 9Johnstown, PA 15904-3374

Mailing Address1450 Scalp Ave, Suite 9Johnstown, PA 15904-3374 · (814) 266-1185 · Fax (814) 266-1199

Phone(814) 266-1185

Fax(814) 266-1199

Sole ProprietorNo

Medical School CMSHarvard Medical SchoolGraduated 1993

Enumeration DateOctober 10, 2005

Last NPPES UpdateJuly 13, 2026

✔ NPI 1609864115 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOtolaryngology · Plastic Surgery within the Head & NeckAllopathic & Osteopathic Physicians

Taxonomy Code207YX0007X

License✔ Licensed in PA · MD064804L

Definition

An otolaryngologist with additional training in plastic and reconstructive procedures within the head, face, neck and associated structures, including cutaneous head and neck oncology and reconstruction, management of maxillofacial trauma, soft tissue repair and neural surgery. The field is diverse and involves a wide age range of patients, from the newborn to the aged. While both cosmetic and reconstructive surgeries are practiced, there are many additional procedures which interface with them.

1450 SCALP AVE, Johnstown, PA 15904

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter Health, Ambetter Health of Delaware.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. Sumeet Mathur 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 ID4284530130

PECOS Enrollment IDI20031210000977, I20230814004179

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 Reassignment

Medicare enrollment records show Sumeet Mathur reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Laurel Ent & Allergy PC

28 mi

Plastic Surgery within the Head & Neck

850 HOSPITAL RD, SUITE 2100
Indiana, PA 15701

Reassigned Medicare billing, Pennsylvania and West Virginia enrollments
2 clinicians in this Medicare group

NPI 1649387515 (724) 349-4360

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.

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.

2,550 services36 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.

576 services12 patients

Test for allergy using allergenic extract injected into skin 95024

An allergy skin test involves injecting a small amount of allergenic extract into your skin. This test helps determine if you're allergic to specific substances. If allergic, a small red bump appears at the test site. It's safe and quick.

253 services12 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.

132 services62 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.

106 services16 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.

58 services37 patients

Hospital Affiliations CMS Care Compare

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

Indiana Regional Medical Center

Acute Care Hospitals · Indiana, PA

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number390173

Location835 Hospital RoadIndiana, PA 15701 · Indiana County

Emergency services Birthing friendly

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.

DR. SAHAR ELIAS MD

Family Medicine

1450 SCALP AVE, SUITE 1000
JOHNSTOWN, PA 15904

Cambria County (814) 269-5200

MR. KEVIN JOSEPH GREEN P.A

Physician Assistant

1450 SCALP AVE, SUITE 106
JOHNSTOWN, PA 15904

Cambria County (814) 266-8466

ERIN LYNN MARTELLA PA-C

Physician Assistant

1450 SCALP AVE, SUITE 106
JOHNSTOWN, PA 15904

Cambria County (814) 266-8466

CONEMAUGH HEALTH INITIATIVES

Psychologist

1450 SCALP AVE
JOHNSTOWN, PA 15904

Cambria County (814) 262-4236

CONEMAUGH HEALTH INITIATIVES

Emergency Medicine

1450 SCALP AVE
JOHNSTOWN, PA 15904

Cambria County (814) 269-5200

CONEMAUGH HEALTH INITIATIVES

Family Medicine

1450 SCALP AVE
JOHNSTOWN, PA 15904

Cambria County (814) 266-1189

LUCINDA MARSH

Registered Nurse

1450 SCALP AVE
JOHNSTOWN, PA 15904

Cambria County (814) 955-7475

KEVIN T MURTHA MD

Family Medicine

1450 SCALP AVE, SUITE 003B
JOHNSTOWN, PA 15904

Cambria County (814) 269-9551

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 Sumeet Mathur's NPI number?

The NPI number for Sumeet Mathur is 1609864115. It was assigned to this individual provider in the NPPES registry on October 10, 2005.

Where is Sumeet Mathur located?

Sumeet Mathur practices at 1450 Scalp Ave Suite 9, Johnstown, PA 15904. The listed phone number is (814) 266-1185.

What is Sumeet Mathur's specialty?

The primary specialty registered for this NPI is Otolaryngology, specializing in Plastic Surgery within the Head & Neck, with taxonomy code 207YX0007X.

Is Sumeet Mathur enrolled in Medicare?

Yes. Sumeet 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.

Which organization bills Medicare for Sumeet Mathur's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Sumeet Mathur reassigns Medicare benefits to Laurel Ent & Allergy PC (Indiana, PA). The 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 Sumeet Mathur's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Sumeet Mathur accept?

Health plans from Ambetter Health, Ambetter Health of Delaware and Ambetter from Buckeye Health Plan list Sumeet 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 Sumeet Mathur affiliated with any hospitals?

According to CMS data, Sumeet Mathur is affiliated with Indiana Regional Medical Center.

When was this NPI record last updated?

The NPPES record for Sumeet Mathur was last updated on July 13, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.