MATHEW SCOTT MARGOLIS MD
NPI 1902367899
Ophthalmology - Cornea and External Diseases Specialist in Sacramento, CA

Q: What is Mathew Margolis's NPI number?

The NPI number for Mathew Margolis is 1902367899. It was assigned to this individual provider in the NPPES registry on March 25, 2019.

Q: What is Mathew Margolis's specialty?

The primary specialty registered for this NPI is Ophthalmology, specializing in Cornea and External Diseases Specialist, with taxonomy code 207WX0120X.

Q: When was this NPI record last updated?

The NPPES record for Mathew Margolis was last updated on August 19, 2024. 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.

Active since March 25, 2019PECOS EnrolledAccepts Medicare Assignment

76.5/100

CMS Quality Rating

4860 Y ST, SACRAMENTO, CA 95817(916) 734-6602 Get Directions Write a Review

NPPES record last updated: August 19, 2024. Verified against the NPPES registry weekly; last sync: September 13, 2026.

Record update history: Aug 19, 2024, Apr 4, 2024, Jul 7, 2023 and 3 more (6 updates tracked since 2020).

On this page

About Mathew Scott Margolis Md NPPES

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

MATHEW SCOTT MARGOLIS MD (NPI 1902367899) is an individual cornea and external diseases specialist in Sacramento, California, licensed in California (A185622) and active in the NPI registry since March 2019. He is enrolled in Medicare PECOS and is a graduate of Washington University School Of Medicine (2019).

NPPES Registry Identity

NPI1902367899

Entity TypeIndividualMale

Primary Taxonomy207WX0120X

Provider Legal NameMATHEW SCOTT MARGOLISCredential: MD

Location Address4860 Y STSacramento, CA 95817-2307

Mailing Address300 Pasteur DrStanford, CA 94305-2200 · (650) 723-4000

Phone(916) 734-6602

Sole ProprietorNo

Medical School CMSWashington University School Of MedicineGraduated 2019

Enumeration DateMarch 25, 2019

Last NPPES UpdateAugust 19, 20246 updates tracked since enumeration

NPPES CertifiedAugust 19, 2024

✔ NPI 1902367899 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyOphthalmology · Cornea and External Diseases SpecialistAllopathic & Osteopathic Physicians

Taxonomy Code207WX0120X

License✔ Licensed in CA · A185622

Definition

An ophthalmologist who specializes in diseases of the cornea, sclera, eyelids, conjunctiva, and anterior segment of the eye.

Also ListedOphthalmologyTaxonomy 207W00000X · License A185622 (CA)

4860 Y ST, Sacramento, CA 95817

Open in Google Maps ↗

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Providence Health Plan.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

Mathew Scott Margolis 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 ID4789002726

PECOS Enrollment IDI20230623001893

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 13

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.

50 services31 patients

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

48 services31 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.

25 services25 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.

25 services23 patients

Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more 99212

This is a routine check-up for patients who have previously seen the doctor. During this 10-19 minute visit, the doctor will review your health status, discuss any concerns, and manage ongoing treatments or medications. It's a chance to ensure your health is on track.

20 services19 patients

Ct scan of cornea 92025

A CT scan of the cornea is a non-invasive imaging test that uses X-rays to capture detailed pictures of your eye's cornea. It helps in diagnosing diseases or damage, planning for surgery, or evaluating the results of a treatment. It's a safe and painless procedure.

17 services16 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.

17 services17 patients

Imaging of retina 92134

Imaging of the retina is a non-invasive procedure that captures detailed images of your eye's interior. This helps detect conditions like macular degeneration or retinal detachment. It's painless and takes only a few minutes.

16 services12 patients

Measurement of corneal curvature and depth of eye 92136

This procedure measures the shape and depth of your eye, specifically the cornea, the clear front surface. It helps in diagnosing conditions, planning for surgeries, or fitting contact lenses. It's non-invasive and painless.

16 services16 patients

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

16 services13 patients

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

15 services15 patients

Ultrasound scan of cornea to determine thickness 76514

An ultrasound scan of the cornea is a non-invasive procedure that uses sound waves to measure the thickness of your cornea. This helps in diagnosing certain eye conditions and planning treatments. No discomfort or pain is typically experienced.

14 services13 patients

Transplantation of outer layer of corneal tissue 65756

The transplantation of the outer layer of corneal tissue is a procedure to replace damaged or diseased corneal tissue with healthy tissue from a donor. This can improve vision and alleviate pain or discomfort.

13 services13 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 95817 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

$137.20 typical visit price

range $60.44 – $180.85

Typical copayment $34.30 (range $15.11 – $45.21)

Most-billed visit code 99204

Established Patient

$75.03 typical visit price

range $19.88 – $148.15

Typical copayment $18.75 (range $4.97 – $37.03)

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.

76.5/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored as part of a group practice

Quality

74.31

Promoting Interoperability

100

Improvement Activities

Cost

43.95

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.

MICHELLE PALVOLGYI M.D.

Student in an Organized Health Care Education/Training Program

4860 Y ST, SUITE 3850
SACRAMENTO, CA 95817

Sacramento County (916) 734-5292

KATHRYN D NEWELL M.D.

Internal Medicine

4860 Y ST, SUITE 0101
SACRAMENTO, CA 95817

Sacramento County (916) 734-4843

DR. SARAH GONG MD

Internal Medicine

4860 Y ST, SUITE 0100
SACRAMENTO, CA 95817

Sacramento County (916) 734-3514

BRIAN JOVES M.D.

Physical Medicine & Rehabilitation

4860 Y ST, SUITE 3850
SACRAMENTO, CA 95817

Sacramento County (916) 734-5292

JAYLA WATKINS MD

Obstetrics & Gynecology

4860 Y ST
SACRAMENTO, CA 95817

Sacramento County (916) 734-6978

JONATHAN BINDI MD

General Acute Care Hospital

4860 Y ST
SACRAMENTO, CA 95817

Sacramento County (916) 734-6602

REGENTS OF THE UNIV OF CA

Obstetrics & Gynecology (Maternal & Fetal Medicine)

4860 Y ST
SACRAMENTO, CA 95817

Sacramento County (916) 734-6930

DR. SANDHYA VENUGOPAL M.D.

Internal Medicine (Cardiovascular Disease)

4860 Y ST, SUITE 2820
SACRAMENTO, CA 95817

Sacramento County (916) 734-3764

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 Mathew Margolis's NPI number?

The NPI number for Mathew Margolis is 1902367899. It was assigned to this individual provider in the NPPES registry on March 25, 2019.

Where is Mathew Margolis located?

Mathew Margolis practices at 4860 Y St, Sacramento, CA 95817. The listed phone number is (916) 734-6602.

What is Mathew Margolis's specialty?

The primary specialty registered for this NPI is Ophthalmology, specializing in Cornea and External Diseases Specialist, with taxonomy code 207WX0120X.

Is Mathew Margolis enrolled in Medicare?

Yes. Mathew Margolis 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 Mathew Margolis accept?

Health plans from Providence Health Plan list Mathew Margolis 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.

When was this NPI record last updated?

The NPPES record for Mathew Margolis was last updated on August 19, 2024. 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.