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CESAR A MATOS-MARTINEZ MD
NPI 1639240575
Psychiatry & Neurology - Psychiatry in Edinburg, TX

Active since November 13, 2006PECOS EnrolledAccepts Medicare Assignment
2110 W TRENTON RD STE A, EDINBURG, TX 78539(956) 289-8200(956) 289-8218 Get Directions Write a Review

NPPES record last updated: September 12, 2023. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Cesar A Matos-martinez Md NPPES

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

CESAR A MATOS-MARTINEZ MD (NPI 1639240575) is an individual psychiatry provider in Edinburg, Texas, licensed in Texas (J3549) and active in the NPI registry since November 2006. He is enrolled in Medicare PECOS, is affiliated with South Texas Health System, and is a graduate of Other (1976).

NPPES Registry Identity

NPI1639240575
Entity TypeIndividualMale
Primary Taxonomy2084P0800X
Provider Legal NameCESAR A MATOS-MARTINEZCredential: MD
Location Address2110 W TRENTON RD STE AEdinburg, TX 78539-4683
Mailing Address2110 W Trenton Rd Ste AEdinburg, TX 78539-4674 · (956) 289-8200 · Fax (956) 289-8218
Phone(956) 289-8200
Fax(956) 289-8218
Sole ProprietorNo
Medical School CMSOtherGraduated 1976
Enumeration DateNovember 13, 2006
Last NPPES UpdateSeptember 12, 2023
NPPES CertifiedSeptember 12, 2023
✔ NPI 1639240575 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychiatry & Neurology · PsychiatryAllopathic & Osteopathic Physicians
Taxonomy Code2084P0800X
License✔ Licensed in TX · J3549
Definition
A Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, anxiety disorders, substance-related disorders, sexual and gender identity disorders and adjustment disorders. Biologic, psychological, and social components of illnesses are explored and understood in treatment of the whole person. Tools used may include diagnostic laboratory tests, prescribed medications, evaluation and treatment of psychological and interpersonal problems with individuals and families, and intervention for coping with stress, crises, and other problems.
2110 W TRENTON RD STE A, Edinburg, TX 78539
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Other Identifiers 1

Medicaid110567801TX

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arizona Complete Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections 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

Cesar A Matos-martinez 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 ID6103844832
PECOS Enrollment IDI20051110000495
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.

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232
Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.
469 services43 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.
402 services139 patients
Hospital discharge day management, 30 minutes or less 99238
Hospital discharge day management of 30 minutes or less includes finalizing your treatment, discussing your progress, and planning after-care at home. It ensures you're ready to leave the hospital and continue recovery safely.
65 services43 patients
Psychotherapy with evaluation and management visit, 30 minutes 90833
Psychotherapy with evaluation and management is a 30-minute session where a mental health professional talks with you about your concerns and feelings. They assess your mental health, provide support, and manage your treatment plan to help improve your well-being.
58 services43 patients
Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes 99222
Initial hospital inpatient care is a service where a healthcare provider spends about 50 minutes per day overseeing your care while you're admitted in the hospital. This includes reviewing your health status, planning your treatment, and ensuring your safety and comfort.
56 services42 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.
52 services26 patients

Hospital Affiliations CMS Care Compare

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

South Texas Health System

Acute Care Hospitals · Edinburg, TX
3/5 CMS rating
OwnershipProprietary
CMS Certification Number450119
Location1102 W Trenton RoadEdinburg, TX 78539 · Hidalgo County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 78539 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
$166.88 typical visit price
range $54.84 – $166.88
Typical copayment $41.72 (range $13.71 – $41.72)
Most-billed visit code 99205
Established Patient
$68.55 typical visit price
range $17.52 – $136.11
Typical copayment $17.13 (range $4.38 – $34.02)
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.

Reported Quality Measures

Adult Major Depressive Disorder (MDD): Suicide Risk Assessment
Percentage of patients aged 18 years and older with a diagnosis of major depressive disorder (MDD) with a suicide risk assessment completed during the visit in which a new diagnosis or recurrent episode was identified
56%134 patients3/55-star benchmark: 99%
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
4%902 patients1/55-star benchmark: 95%
Dementia: Cognitive Assessment
Percentage of patients, regardless of age, with a diagnosis of dementia for whom an assessment of cognition is performed and the results reviewed at least once within a 12-month period
73%41 patients3/55-star benchmark: 100%
Depression Utilization of the PHQ-9 Tool
The percentage of patients age 18 and older with the diagnosis of major depression or dysthymia who have a completed PHQ-9 during each applicable 4 month period in which there was a qualifying visit
Patients 4MonthsOfEnd: 22% · 437 patients
Patients 4MonthsOfStart: 24% · 441 patients
14%433 patients
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%5,366 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.
100%1,315 patients5/55-star benchmark: 100%
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…
91%698 patients4/55-star benchmark: 96%
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.
100%48 patients5/55-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.
100%1,106 patients5/55-star benchmark: 99%
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…
99%1,484 patients5/55-star benchmark: 97%
Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention
Percentage of patients aged 18 years and older who were screened for tobacco use one or more times within 24 months AND who received tobacco cessation intervention if identified as a tobacco user
0%1,327 patients
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…
100%1,106 patients5/55-star benchmark: 100%
Secure Messaging
For at least one unique patient seen by the MIPS eligible clinician during the performance period, a secure message was sent using the electronic messaging function of CEHRT to the patient (or the patient-authorized representative), or in response to a secure…
45%1,106 patients4/55-star benchmark: 59%
Use of High-Risk Medications in the Elderly
Percentage of patients 65 years of age and older who were ordered high-risk medications. Two rates are submitted. 1) Percentage of patients who were ordered at least one high-risk medication.
Lower rates are better for this measure.
Patients 2+: 1% · 305 patients
5%305 patients4/55-star benchmark: 100%
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.

Patient Reviews User submitted

Reviews are submitted by site visitors and approved by a human moderator before publication.

Review by Angel ***** May 23, 2025

5/5
I like the way he works. Treats you like family and listens to you.....
Provider 5/5 Office Staff 5/5
Visited this provider? Share your experience.

Other Providers at the Same Location NPPES 4

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

CESAR A MATOS, M.D.,P.A.
Psychiatry & Neurology (Psychiatry)
2110 W TRENTON RD STE A
EDINBURG, TX 78539
Hidalgo County (956) 289-8241
KENIA JISELLE TREVINO LPC ASSOCIATE
Counselor (Mental Health)
2110 W TRENTON RD STE A
EDINBURG, TX 78539
Hidalgo County (956) 672-7500
MARIANN VILLARREAL
Counselor (Professional)
2110 W TRENTON RD STE A
EDINBURG, TX 78539
Hidalgo County (832) 869-4818
EMILIA ANTONIA FILIPPONE M.S., LPC-ASSOCIATE
Counselor (Professional)
2110 W TRENTON RD STE A
EDINBURG, TX 78539
Hidalgo County (956) 672-7500

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 Cesar Matos-martinez's NPI number?

The NPI number for Cesar Matos-martinez is 1639240575. It was assigned to this individual provider in the NPPES registry on November 13, 2006.

Where is Cesar Matos-martinez located?

Cesar Matos-martinez practices at 2110 W Trenton Rd Ste A, Edinburg, TX 78539. The listed phone number is (956) 289-8200.

What is Cesar Matos-martinez's specialty?

The primary specialty registered for this NPI is Psychiatry & Neurology, specializing in Psychiatry, with taxonomy code 2084P0800X.

Is Cesar Matos-martinez enrolled in Medicare?

Yes. Cesar Matos-martinez 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 Cesar Matos-martinez accept?

Health plans from Ambetter Health, Ambetter from Arizona Complete Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections and Ambetter from Superior HealthPlan and 7 other insurers list Cesar Matos-martinez 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 Cesar Matos-martinez affiliated with any hospitals?

According to CMS data, Cesar Matos-martinez is affiliated with South Texas Health System.

When was this NPI record last updated?

The NPPES record for Cesar Matos-martinez was last updated on September 12, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.