NALIN MATHUR MD PA
NPI 1891791935
Internal Medicine in Waldorf, MD

Active since June 23, 2005PECOS EnrolledAccepts Medicare Assignment
86/100
CMS Quality Rating
11855 HOLLY LANE, #107, WALDORF, MD 20601(301) 638-2733(301) 638-3377 Get Directions Write a Review

NPPES record last updated: September 27, 2012. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Nalin Mathur Md Pa NPPES

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

NALIN MATHUR MD PA (NPI 1891791935) is an individual internal medicine provider in Waldorf, Maryland, licensed in Maryland (D52289) and active in the NPI registry since June 2005. He is enrolled in Medicare PECOS and is a graduate of Other (1992).

NPPES Registry Identity

NPI1891791935
Entity TypeIndividualMale
Primary Taxonomy207R00000X
Provider Legal NameNALIN MATHURCredential: MD PA
Location Address11855 HOLLY LANE, #107Waldorf, MD 20601-3114
Mailing AddressPo Box 7436Alexandria, VA 22307-0436 · (301) 638-2733 · Fax (301) 638-3377
Fax(301) 638-3377
Sole ProprietorNo
Medical School CMSOtherGraduated 1992
Enumeration DateJune 23, 2005
Last NPPES UpdateSeptember 27, 2012
NPI 1891791935 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
License Licensed in MD · D52289
Definition
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
11855 HOLLY LANE, Waldorf, MD 20601

Other Identifiers 3

Medicare ID-Type Unspecified490881MD · P.g. County
Medicare UPING59991MD
Medicare ID-Type Unspecified504RMD · Southern Md

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

Nalin Mathur Md Pa 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 ID1951306869
PECOS Enrollment IDI20060928000143
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 19

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.
1,284 services275 patients
Telephone medical discussion with physician, 11-20 minutes 99442
This is a service where you have a phone conversation with your doctor for 11-20 minutes. It's used for discussing health concerns, reviewing test results, or managing ongoing conditions. It's a convenient way to receive medical advice without an in-person visit.
1,073 services262 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.
259 services152 patients
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439
An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.
181 services181 patients
Ultrasound study of arm and leg arteries 93922
An ultrasound study of arm and leg arteries is a non-invasive procedure that uses sound waves to create images of your arteries. It helps in checking blood flow, identifying blockages, or detecting other abnormalities in your arteries.
157 services151 patients
Administration of influenza virus vaccine G0008
The administration of the influenza virus vaccine, also known as the flu shot, is a simple procedure to protect against the flu. A healthcare provider injects a small dose of the vaccine into your arm. This stimulates your immune system to produce antibodies, which will help your body fight off the flu if exposed.
146 services145 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 20601 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
$133.05 typical visit price
range $57.99 – $175.57
Typical copayment $33.26 (range $14.49 – $43.89)
Most-billed visit code 99204
Established Patient
$102.11 typical visit price
range $18.66 – $143.02
Typical copayment $25.52 (range $4.66 – $35.75)
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.

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.

86/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Individually scored
Quality90
Improvement Activities20
Cost100

Reported Quality Measures

Diabetes: Medical Attention for Nephropathy
The percentage of patients 18-75 years of age with diabetes who had a nephropathy screening test or evidence of nephropathy during the measurement period
91%328 patients4/55-star benchmark: 99%
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%15,963 patients4/55-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.
2%1,509 patients1/55-star benchmark: 100%
Pneumococcal Vaccination Status for Older Adults
Percentage of patients 65 years of age and older who have ever received a pneumococcal vaccine
28%275 patients2/55-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…
22%1,492 patients1/55-star benchmark: 97%
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…
35%1,509 patients2/55-star benchmark: 100%
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+: 5% · 275 patients
17%275 patients1/55-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.

Referred Medical Equipment & Supplies CMS DME claims 4

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

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253
DME-Other DME · category DE017N
13 suppliers39 claims91 services$6.30 avg. paid by Medicare
Lancets, per box of 100 A4259
DME-Medical/Surgical Supplies · category DA000N
8 suppliers15 claims22 services$1.19 avg. paid by Medicare
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress E0260
DME-Hospital Beds · category DB000N
2 suppliers16 claims16 services$49.51 avg. paid by Medicare
Supply allowance for therapeutic continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service K0553
DME-Other DME · category DE017N
10 suppliers58 claims58 services$193.67 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

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

Dentist
11855 HOLLY LANE, SUITE 103
WALDORF, MD 20601

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 Nalin Mathur's NPI number?

The NPI number for Nalin Mathur is 1891791935. It was assigned to this individual provider in the NPPES registry on June 23, 2005.

Where is Nalin Mathur located?

Nalin Mathur practices at 11855 Holly Lane #107, Waldorf, MD 20601. The listed phone number is (301) 638-2733.

What is Nalin Mathur's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Is Nalin Mathur enrolled in Medicare?

Yes. Nalin 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.

When was this NPI record last updated?

The NPPES record for Nalin Mathur was last updated on September 27, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 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.