DR. KENNETH B MATHIS M.D.
NPI 1912940487
Orthopaedic Surgery in Houston, TX

Q: What is Kenneth Mathis's NPI number?

The NPI number for Kenneth Mathis is 1912940487. It was assigned to this individual provider in the NPPES registry on June 13, 2006.

Q: What is Kenneth Mathis's specialty?

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

Q: When was this NPI record last updated?

The NPPES record for Kenneth Mathis was last updated on July 25, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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 June 13, 2006PECOS EnrolledAccepts Medicare Assignment

82.38/100

CMS Quality Rating

6400 FANNIN ST STE 1700, HOUSTON, TX 77030(713) 486-5555(713) 486-7533 Get Directions Write a Review

NPPES record last updated: July 25, 2022. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Dr. Kenneth B Mathis M.d. NPPES

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

DR. KENNETH B MATHIS M.D. (NPI 1912940487) is an individual orthopaedic surgery provider in Houston, Texas, licensed in Texas (H0610) and active in the NPI registry since June 2006. He is enrolled in Medicare PECOS, is affiliated with Memorial Hermann - Texas Medical Center, and is a graduate of University Of Texas Southwestern Medical School At Dallas (1985).

NPPES Registry Identity

NPI1912940487

Entity TypeIndividualMale

Primary Taxonomy207X00000X

Provider Legal NameDR. KENNETH B MATHISCredential: M.D.

Location Address6400 FANNIN ST STE 1700Houston, TX 77030-1526

Mailing Address6400 Fannin St Ste 1700Houston, TX 77030-1526 · (713) 486-5555 · Fax (713) 486-7533

Phone(713) 486-5555

Fax(713) 486-7533

Sole ProprietorNo

Medical School CMSUniversity Of Texas Southwestern Medical School At DallasGraduated 1985

Enumeration DateJune 13, 2006

Last NPPES UpdateJuly 25, 2022

NPPES CertifiedJuly 25, 2022

✔ NPI 1912940487 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyOrthopaedic SurgeryAllopathic & Osteopathic Physicians

Taxonomy Code207X00000X

License✔ Licensed in TX · H0610

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.

Also ListedOrthopaedic Surgery · Adult Reconstructive Orthopaedic SurgeryTaxonomy 207XS0114X · License H0610 (TX)

6400 FANNIN ST STE 1700, Houston, TX 77030

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Other Identifiers 1

Other8S9717TX · Bcbs

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

Dr. Kenneth B Mathis 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 ID6204870025

PECOS Enrollment IDI20050613001220

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 11

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.

X-ray of knee, 3 views 73562

An X-ray of the knee, 3 views, is a non-invasive imaging test. It uses a small amount of radiation to produce images of the knee from three different angles. This helps medical professionals to diagnose and monitor conditions like arthritis, fractures, or infections. The process is quick and painless.

275 services200 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.

108 services102 patients

X-ray of hip, 2-3 views 73502

An X-ray of the hip with 2-3 views is a non-invasive imaging test. It uses a small amount of radiation to produce pictures of the hip joint. These images help in diagnosing conditions like fractures, arthritis, or other abnormalities. The process is quick and painless.

107 services95 patients

Replacement of knee joint, both sides of knee 27447

A bilateral knee joint replacement is a procedure where the damaged parts of both your knee joints are replaced with artificial parts. It aims to relieve pain and improve mobility. The process involves a surgical operation under anesthesia.

84 services81 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.

62 services61 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.

49 services49 patients

Hospital Affiliations CMS Care Compare 5

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

Memorial Hermann - Texas Medical Center

Acute Care Hospitals · Houston, TX

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number450068

Location6411 FanninHouston, TX 77030 · Harris County

Emergency services Birthing friendly

Memorial Hermann Hospital System

Acute Care Hospitals · Houston, TX

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number450184

Location1635 North Loop WestHouston, TX 77008 · Harris County

Emergency services Birthing friendly

Houston Methodist Hospital

Acute Care Hospitals · Houston, TX

5/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number450358

Location6565 FanninHouston, TX 77030 · Harris County

Emergency services Birthing friendly

Memorial Hermann Memorial City Hospital

Acute Care Hospitals · Houston, TX

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number450610

Location921 GessnerHouston, TX 77024 · Harris County

Emergency services Birthing friendly

Memorial Hermann Northeast Hospital

Acute Care Hospitals · Humble, TX

2/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number450684

Location18951 Memorial NorthHumble, TX 77338 · Harris County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 77030 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

$90.40 typical visit price

range $58.24 – $176.98

Typical copayment $22.60 (range $14.56 – $44.24)

Most-billed visit code 99203

Established Patient

$72.62 typical visit price

range $18.60 – $143.93

Typical copayment $18.15 (range $4.65 – $35.98)

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.

82.38/100

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

Scored as part of a group practice

Quality

79.23

Promoting Interoperability

100

Improvement Activities

Cost

58.5

Referred Medical Equipment & Supplies CMS DME claims

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

Walker, folding, wheeled, adjustable or fixed height E0143

DME-Other DME · category DE000N

1 supplier69 claims69 services$44.17 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 20

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

DR. WALTER RICHARD LOWE MD

Orthopaedic Surgery (Sports Medicine)