MATTHEW WHARTON
NPI 1700249133
Orthopaedic Surgery in Albuquerque, NM

Active since April 02, 2016PECOS EnrolledAccepts Medicare Assignment
85.18/100
CMS Quality Rating
MSC 10 5600, 1 UNIVERSITY OF NEW MEXICO, ALBUQUERQUE, NM 87131(505) 272-4107 Get Directions Write a Review

NPPES record last updated: October 29, 2024. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Jul 24, 2023, Aug 31, 2022, Jun 16, 2021 and 1 more (4 updates tracked since 2016).

About Matthew Wharton NPPES

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

MATTHEW WHARTON (NPI 1700249133) is an individual orthopaedic surgery provider in Albuquerque, New Mexico, licensed in New Mexico (MD2021-0620) and active in the NPI registry since April 2016. He is enrolled in Medicare PECOS, is affiliated with Unm Hospital, and maintains a secondary practice location in Lexington.

NPPES Registry Identity

NPI1700249133
Entity TypeIndividualMale
Primary Taxonomy207X00000X
Provider Legal NameMATTHEW WHARTON
Location AddressMSC 10 5600, 1 UNIVERSITY OF NEW MEXICOAlbuquerque, NM 87131-0001
Mailing Address800 Bradbury Dr Se Ste 116Albuquerque, NM 87106-4310 · (505) 272-1476
Sole ProprietorNo
Medical School CMSOtherGraduated 2016
Enumeration DateApril 2, 2016
Last NPPES UpdateOctober 29, 20244 updates tracked since enumeration
NPPES CertifiedOctober 29, 2024
NPI 1700249133 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtyOrthopaedic SurgeryAllopathic & Osteopathic Physicians
Taxonomy Code207X00000X
Licenses Licensed in NM · MD2021-0620 Licensed in KY · 55073
Definition

An orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated structures by medical, surgical and physical means. An orthopaedic surgeon is involved with the care of patients whose musculoskeletal problems include congenital deformities, trauma, infections, tumors, metabolic disturbances of the musculoskeletal system, deformities, injuries and degenerative diseases of the spine, hands, feet, knee, hip, shoulder and elbow in children and adults. An orthopaedic surgeon is also concerned with primary and secondary muscular problems and the effects of central or peripheral nervous system lesions of the musculoskeletal system.

MSC 10 5600, Albuquerque, NM 87131

Secondary Practice Location 1

Location 1740 S Limestone, Ste D135Lexington, KY 40536 · Phone (859) 323-5533 · Fax (859) 257-3634

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 Wharton 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 ID2264728948
PECOS Enrollment IDI20220914002260
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 5

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 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.
48 services34 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.
48 services35 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.
17 services17 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.
13 services13 patients
Initial hospital care with straightforward or low level of medical decision making, per day, if using time, at least 40 minutes 99221
Initial hospital inpatient care refers to the first day of your stay in the hospital. This service typically includes a 30-minute check-up with a healthcare professional. They'll assess your health, discuss your condition, and plan your treatment. It's part of ensuring you receive the best possible care.
12 services12 patients

Hospital Affiliations CMS Care Compare

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

Unm Hospital

Acute Care Hospitals · Albuquerque, NM
2/5 CMS rating
OwnershipGovernment - State
CMS Certification Number320001
Location2211 Lomas Boulevard NEAlbuquerque, NM 87106 · Bernalillo County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 87131 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
$84.79 typical visit price
range $54.26 – $166.80
Typical copayment $21.19 (range $13.56 – $41.70)
Most-billed visit code 99203
Established Patient
$68.00 typical visit price
range $17.00 – $135.35
Typical copayment $17.00 (range $4.25 – $33.83)
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.

85.18/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality81
Promoting Interoperability100
Improvement Activities40
Cost57.08

Other Providers at the Same Location NPPES

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

Orthopaedic Surgery (Orthopaedic Surgery of the Spine)
MSC 10 5600, 1 UNIVERSITY OF NEW MEXICO
ALBUQUERQUE, NM 87131

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 Matthew Wharton's NPI number?

The NPI number for Matthew Wharton is 1700249133. It was assigned to this individual provider in the NPPES registry on April 2, 2016.

Where is Matthew Wharton located?

Matthew Wharton practices at Msc 10 5600 1 University Of New Mexico, Albuquerque, NM 87131. The listed phone number is (505) 272-4107.

What is Matthew Wharton's specialty?

The primary specialty registered for this NPI is Orthopaedic Surgery with taxonomy code 207X00000X.

Is Matthew Wharton enrolled in Medicare?

Yes. Matthew Wharton 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.

Is Matthew Wharton affiliated with any hospitals?

According to CMS data, Matthew Wharton is affiliated with Unm Hospital.

When was this NPI record last updated?

The NPPES record for Matthew Wharton was last updated on October 29, 2024. NPI Profile syncs with the weekly NPPES data releases published by CMS.