MATTHEW THOMAS SPROUL M.D.
NPI 1619005204
Family Medicine in Garner, NC

Q: What is Matthew Sproul's NPI number?

The NPI number for Matthew Sproul is 1619005204. It was assigned to this individual provider in the NPPES registry on March 2, 2007.

Q: What is Matthew Sproul's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Q: When was this NPI record last updated?

The NPPES record for Matthew Sproul was last updated on December 29, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.

Active since March 02, 2007PECOS EnrolledAccepts Medicare Assignment

811 US 70 HWY W, GARNER, NC 27529(919) 235-6565(919) 235-6596 Get Directions Write a Review

NPPES record last updated: December 29, 2022. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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About Matthew Thomas Sproul M.d. NPPES

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

MATTHEW THOMAS SPROUL M.D. (NPI 1619005204) is an individual family medicine provider in Garner, North Carolina, licensed in North Carolina (2007-00996) and active in the NPI registry since March 2007. He is enrolled in Medicare PECOS, is affiliated with Wakemed, Raleigh Campus, and maintains 3 additional practice locations.

NPPES Registry Identity

NPI1619005204

Entity TypeIndividualMale

Primary Taxonomy207Q00000X

Provider Legal NameMATTHEW THOMAS SPROULCredential: M.D.

Location Address811 US 70 HWY WGarner, NC 27529-2541

Mailing AddressPo Box 603949Charlotte, NC 28260-3949 · (919) 350-9713 · Fax (919) 350-7687

Phone(919) 235-6565

Fax(919) 235-6596

Sole ProprietorNo

Medical School CMSUniversity Of North Carolina At Chapel Hill School Of MedicineGraduated 2005

Enumeration DateMarch 2, 2007

Last NPPES UpdateDecember 29, 2022

NPPES CertifiedDecember 29, 2022

✔ NPI 1619005204 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207Q00000X

License✔ Licensed in NC · 2007-00996

Definition

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

811 US 70 HWY W, Garner, NC 27529

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Secondary Practice Locations 3

Location 1231 N Judd Pkwy NEFuquay Varina, NC 27526-2694 · Phone (919) 235-6560 · Fax (919) 235-6597

Location 22930 Forestville RdRaleigh, NC 27616-8774 · Phone (919) 235-6500 · Fax (919) 235-6585

Location 3110 Kildaire Park DrCary, NC 27518-8162 · Phone (919) 859-1136 · Fax (919) 859-4240

Other Identifiers 1

Medicaid5909877NC

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Absolute Total Care, Ambetter of North Carolina, Ambetter of Tennessee 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

Matthew Thomas Sproul 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 ID1951476654

PECOS Enrollment IDI20080814000466

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 8

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.

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.

204 services192 patients

Automated urinalysis test 81003

An automated urinalysis test is a routine examination that checks your urine for various substances. It can help identify potential health issues such as kidney problems or diabetes. The test uses a machine to analyze a small urine sample, providing quick and accurate results.

51 services48 patients

Detection test by immunoassay technique for severe acute respiratory syndrome coronavirus and influenza 87428

This test uses a method called immunoassay to identify severe acute respiratory syndrome coronavirus and influenza. It works by detecting specific proteins (antigens) in a sample, like a nasal swab. It's a powerful tool in diagnosing these viral infections.

47 services47 patients

X-ray of chest, 2 views 71046

A chest X-ray, 2 views, is a quick, painless test that creates pictures of the structures inside your chest, such as your heart, lungs, and blood vessels. Two different angles are used to get a comprehensive view. This helps in diagnosing conditions like pneumonia, heart problems, or lung cancer.

41 services41 patients

New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203

This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.

41 services41 patients

New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204

This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.

35 services35 patients

Hospital Affiliations CMS Care Compare

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

Wakemed, Raleigh Campus

Acute Care Hospitals · Raleigh, NC

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number340069

Location3000 New Bern AveRaleigh, NC 27610 · Wake County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 27529 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

$83.90 typical visit price

range $54.12 – $165.09

Typical copayment $20.97 (range $13.53 – $41.27)

Most-billed visit code 99203

Established Patient

$95.94 typical visit price

range $17.21 – $134.61

Typical copayment $23.98 (range $4.30 – $33.65)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 10

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

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