MS. KRISTINA MARIE MATTHEWS PA-C
NPI 1942512264
Physician Assistant in Salisbury, MD

NPI Status: Active since July 02, 2010

Contact Information

1340 S DIVISION ST STE 301
SALISBURY, MD
ZIP 21804
Phone: (410) 543-2060
Fax: (410) 543-2051

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  • Individual
  • Female
  • Years of Experience 16
  • Physician Assistant
  • Accepts Medicare Approved Payment
  • PECOS Enrolled
  • Medicare Quality Reporting

About KRISTINA MATTHEWS

This page provides the complete NPI Profile along with additional information for Kristina Matthews, a primary care provider established in Salisbury, Maryland with a medical specialization in Physician Assistant and more than 16 years of experience. The healthcare provider is registered in the NPI registry with number 1942512264 assigned on July 2010. The practitioner's primary taxonomy code is 363A00000X with license number C0004241 (MD). The provider is registered as an individual and her NPI record was last updated 2 years ago.

NPI
1942512264
Provider Name
MS. KRISTINA MARIE MATTHEWS PA-C
Other Name
MS. KRISTINA MARIE GLUNZ PA-C
Other Name Type
Former Name (1)
Gender
Female
Entity Type
Individual
Location Address
1340 S DIVISION ST STE 301 SALISBURY, MD 21804
Location Phone
(410) 543-2060
Location Fax
(410) 543-2051
Mailing Address
PO BOX 1978 SALISBURY, MD 21802
Mailing Phone
(410) 749-1015
Mailing Fax
(410) 543-2051
Medical School Name
OTHER
Graduation Year
2010
Is Sole Proprietor?
No
Enumeration Date
07-02-2010
Last Update Date
12-10-2024
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A primary care provider (PCP) like Kristina Matthews sees people with common medical problems. The primary care provider might be a doctor, physician assistant, nurse practitioner or clinic that are usually involved in your long-term care. A PCP might provide preventive care, treat common medical conditions, identify urgent medical problems and refer you to specialists when necessary. Primary care is usually provided in an outpatient facility but if you are admitted to a hospital your PCP may assist in your care. The most common medical conditions seen by primary care providers are: hypertension, upper respiratory tract infections, depression or anxiety, back pain, arthritis, dermatitis, diabetes, urinary tract infections, etc

Location Map

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Physician Assistant

Taxonomy Code
363A00000X
Type
Physician Assistants & Advanced Practice Nursing Providers
License No.
C0004241
License State
MD
Taxonomy Description
A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Additional Identifiers

The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State Identifier Issuer
119591300MEDICAID (05)MD 

Medicare Participation & PECOS Enrollment Status

Kristina Matthews is registered with Medicare and accepts claims assignment, this means the provider accepts the approved amount for the cost of rendered services as full payment. Participating providers may not charge beneficiaries more than the approved amount for their services. Please keep in mind that beneficiaries still have to pay a coinsurance or copayment amount for a visit or service.

Kristina Matthews is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.

What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.

  • Is the provider registered in PECOS? Yes

  • PECOS PAC ID: 5597981860

    What is the PECOS Associate Control ID?
    A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.

  • PECOS Enrollment ID: I20140722001580

    What is the Provider Enrollment ID?
    The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.

  • Accepts Medicare Assignment? Yes

    What does it mean "accepts medicare assignment"?
    When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
    A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.

  • Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes

  • Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes

  • Eligible to Order or Refer a Home Health Agency (HHA): Yes

  • Eligible to Order or Refer Power Mobility Devices: Yes

Provider Referred Orders for Durable Medical Equipment, Devices & Supplies

The following list reflects the services, supplies or durable medical equipment ordered by this provider to a DME supplier on behalf of patients. The information below is derived from Medicare claims data and reflects the BETOS category, HCPCS code information and the number times each service was submitted under the Medicare fee-for-service program.

Durable Medical Equipment

  • DME-Other DME (DE017N)

    Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips (HCPCS:A4253)

    10 DME suppliers used 24 Medicare Claims 68 Services Paid

  • DME-Medical/Surgical Supplies (DA000N)

    Lancets, per box of 100 (HCPCS:A4259)

    7 DME suppliers used 18 Medicare Claims 18 Services Paid

  • DME-Oxygen and Supplies (DC000N)

    Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing (HCPCS:E0431)

    1 DME suppliers used 21 Medicare Claims 21 Services Paid

  • DME-Oxygen and Supplies (DC002N)

    Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate (HCPCS:E1390)

    1 DME suppliers used 21 Medicare Claims 21 Services Paid

Physician Visit Costs



The typical physician office visit costs for Medicare beneficiaries in this area are: $22.43 for a new patient copayment and $18.05 for an established patient copayment.

The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.

For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.

The prices below reflect the costs for new and established patients in the 21804 ZIP code area.

New Patients Visit Costs *

The most utilized procedure code for new patients office visits is 99203

  • Average New Patient Price $89.75
  • Minimum New Patient Price $57.99
  • Maximum New Patient Price $175.57
  • Average New Patient Copayment $22.43
  • Minimum New Patient Copayment $14.49
  • Maximum New Patient Copayment $43.89

Established Patients Visit Costs *

The most utilized procedure code for established patients office visits is 99213

  • Average Established Patient Price $72.23
  • Minimum Established Patient Price $18.66
  • Maximum Established Patient Price $143.02
  • Average Established Patient Copayment $18.05
  • Minimum Established Patient Copayment $4.66
  • Maximum Established Patient Copayment $35.75

* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.

Quality Reporting

The provider participated in CMS Quality Payment Program. The Quality Payment Program aims to improve population health, reduce costs and improve the care received by Medicare beneficiaries. The following quality measures meet Medicare's statistical reporting standards. Not all providers report the same information, because not all providers give the same services to patients. The quality information is just a snapshot of some the care providers give to their patients. Reporting more or less information is not a reflection of quality.

Quality Measure Performance Number of Patients
Advance Care PlanningYesN/A
Implementation of practices/processes to develop advance care planning that includes: documenting the advance care plan or living will within the medical record, educating clinicians about advance care planning motivating them to address advance care planning needs of their patients, and how these needs can translate into quality improvement, educating clinicians on approaches and barriers to talking to patients about end-of-life and palliative care needs and ways to manage its documentation, as well as informing clinicians of the healthcare policy side of advance care planning.
Breast Cancer Screening 84% 552
Percentage of women 50-74 years of age who had a mammogram to screen for breast cancer
Care transition documentation practice improvementsYesN/A
Implementation of practices/processes for care transition that include documentation of how a MIPS eligible clinician or group carried out a patient-centered action plan for first 30 days following a discharge (e.g., staff involved, phone calls conducted in support of transition, accompaniments, navigation actions, home visits, patient information access, etc.).
Colorectal Cancer Screening 92% 1008
Percentage of adults 50-75 years of age who had appropriate screening for colorectal cancer
Dementia: Cognitive Assessment 4% 24
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
Diabetes: Eye Exam 47% 304
Percentage of patients 18-75 years of age with diabetes who had a retinal or dilated eye exam by an eye care professional during the measurement period or a negative retinal exam (no evidence of retinopathy) in the 12 months prior to the measurement period
Diabetes: Foot Exam 62% 304
The percentage of patients 18-75 years of age with diabetes (type 1 and type 2) who received a foot exam (visual inspection and sensory exam with mono filament and a pulse exam) during the measurement year
Diabetes: Medical Attention for Nephropathy 96% 304
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
Documentation of Current Medications in the Medical Record 99% 3113
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. This list must include ALL known prescriptions, over-the-counters, herbals, and vitamin/mineral/dietary (nutritional) supplements AND must contain the medications' name, dosage, frequency and route of administration
e-Prescribing 98% 3888
At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology.
Falls: Screening for Future Fall Risk 79% 593
Percentage of patients 65 years of age and older who were screened for future fall risk during the measurement period
Immunization Registry ReportingYesN/A
The MIPS eligible clinician is in active engagement with a public health agency to submit immunization data.
Medication Reconciliation 94% 236
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.
Patient-Specific Education 100% 1916
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.
Pneumococcal Vaccination Status for Older Adults 81% 595
Percentage of patients 65 years of age and older who have ever received a pneumococcal vaccine
Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan 46% 2107
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 twelve months of the current encounter Normal Parameters: Age 18 years and older BMI >= 18.5 and < 25 kg/m2
Preventive Care and Screening: Influenza Immunization 59% 1351
Percentage of patients aged 6 months and older seen for a visit between October 1 and March 31 who received an influenza immunization OR who reported previous receipt of an influenza immunization
Preventive Care and Screening: Screening for Depression and Follow-Up Plan 10% 1650
Percentage of patients aged 12 years and older screened for depression on the date of the encounter using an age appropriate standardized depression screening tool AND if positive, a follow-up plan is documented on the date of the positive screen
Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention 23% 209
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
Provide Patient Access 98% 1916
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 certain information.
Secure Messaging 30% 1916
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 message sent by the patient (or the patient-authorized representative) during the performance period.
Security Risk AnalysisYesN/A
Conduct or review a security risk analysis in accordance with the requirements in 45 CFR 164.308(a)(1), including addressing the security (to include encryption) of ePHI data created or maintained by certified EHR technology in accordance with requirements in 45 CFR164.312(a)(2)(iv) and 45 CFR 164.306(d)(3), and implement security updates as necessary and correct identified security deficiencies as part of the MIPS eligible clinician's risk management process.
Statin Therapy for the Prevention and Treatment of Cardiovascular Disease 62% 773
Percentage of the following patients - all considered at high risk of cardiovascular events - who were prescribed or were on statin therapy during the measurement period: - Adults aged >= 21 years who were previously diagnosed with or currently have an active diagnosis of clinical atherosclerotic cardiovascular disease (ASCVD); OR - Adults aged >=21 years who have ever had a fasting or direct low-density lipoprotein cholesterol (LDL-C) level >= 190 mg/dL; OR - Adults aged 40-75 years with a diagnosis of diabetes with a fasting or direct LDL-C level of 70-189 mg/dL
Use of High-Risk Medications in the Elderly 4% "Inverse Quality Measure"
This is an inverse quality measure, a lower rate means the provider is rated better.
595
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. 2) Percentage of patients who were ordered at least two of the same high-risk medication

Find Provider Hospital Affiliations - Privileges

Doctors and physicians must apply for hospital privileges to treat patients at hospitals. Find out if your doctor has privileges to practice at your preferred hospital by using the hospital affiliation information below based on recent medical claims.

Hospital affiliation is identified through self-reporting data, inpatient, outpatient, physician and ancillary service claims linked by the medical claims NPI number and place of service code. Additionally, to further determine provider hospital affiliation the clinician must have provided services to at least three patients on three different dates in the last 12 months. Kristina Matthews is affiliated with the following medical facilities:

Hospital Name Address Phone Hospital Type Overall Rating
TIDALHEALTH PENINSULA REGIONAL, INC100 EAST CARROLL AVENUE
SALISBURY, MD 21801
(410) 546-6400Acute Care Hospitals

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1942512264, we treat the final digit (4) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 56. The final step is to find the difference between that total and the next multiple of ten (60 - 56 = 4).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
9
Unchanged
Pos 3
4
Doubled → 8
Pos 4
2
Unchanged
Pos 5
5
Doubled → 10 → 1 + 0
Pos 6
1
Unchanged
Pos 7
2
Doubled → 4
Pos 8
2
Unchanged
Pos 9
6
Doubled → 12 → 1 + 2
Check
4
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 4 → 8 5 → 10 → 1 2 → 4 6 → 12 → 3

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 9 + 8 + 2 + 1 + 0 + 1 + 4 + 2 + 1 + 2 + 24 = 56

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 56 is 60. The difference is the calculated check digit.

60 - 56 = 4
This NPI is valid
The calculated check digit is 4, which matches the last digit of 1942512264.

Other Providers at the Same Location


The following 8 providers are registered at the same or a nearby location.

Nurse Practitioner (Family)
1340 S DIVISION ST STE 301
SALISBURY, MD 21804
Nurse Practitioner (Family)
1340 S DIVISION ST STE 301
SALISBURY, MD 21804
Internal Medicine
1340 S DIVISION ST STE 301
SALISBURY, MD 21804
Physician Assistant
1340 S DIVISION ST STE 301
SALISBURY, MD 21804
Internal Medicine
1340 S DIVISION ST STE 301
SALISBURY, MD 21804
Pharmacist
1340 S DIVISION ST STE 301
SALISBURY, MD 21804
Nurse Practitioner (Family)
1340 S DIVISION ST STE 301
SALISBURY, MD 21804
Clinic/Center (Federally Qualified Health Center (FQHC))
1340 S DIVISION ST STE 301
SALISBURY, MD 21804

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1942512264, enumerated as an "individual" on July 02, 2010.

The provider is located at 1340 S DIVISION ST STE 301 SALISBURY, MD 21804 and the phone number is (410) 543-2060.

Physician Assistant with taxonomy code 363A00000X.

The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.

Kristina Matthews is affiliated with: TIDALHEALTH PENINSULA REGIONAL, INC.