Kevin R Mathisson, M.D.

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

198609 Issued in NY

Practice address

455 Central Park Ave # 317
Scarsdale, NY 10583-1060

Phone

(914) 723-2020

Fax

(914) 723-2011

NPI assigned

Jun 28, 2006

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in NY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Ophthalmology

Education

Albert Einstein College of Medicine of Yeshiva University, 1991

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Kevin R Mathisson MD PCGroup PAC ID 1951470780, 3 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

75 of 100Reported as group

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Networks

• Healthfirst Medicare Network H5989
• Healthfirst Medicare Network H3359
• Healthfirst Medicare Network H1722

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Kevin R Mathisson MD PC

  • Ophthalmology Physician
  • Scarsdale, NY
  • NPI 1023288610
  Medicare reassignment Care Compare group NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1151452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614124800000",
    "number": "1326076639",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "455 CENTRAL PARK AVE STE 317",
            "city": "SCARSDALE",
            "state": "NY",
            "postal_code": "105831060",
            "telephone_number": "914-723-2020",
            "fax_number": "914-723-2011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "455 CENTRAL PARK AVE # 317",
            "city": "SCARSDALE",
            "state": "NY",
            "postal_code": "105831060",
            "telephone_number": "914-723-2020",
            "fax_number": "914-723-2011"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1075 Central Park Ave",
            "address_2": "Suite 409",
            "address_purpose": "LOCATION",
            "city": "Scarsdale",
            "state": "NY",
            "postal_code": "105833242",
            "country_code": "US",
            "telephone_number": "914-723-2020",
            "fax_number": "914-723-2011",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MATHISSON",
        "first_name": "KEVIN",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-28",
        "last_updated": "2021-02-24",
        "certification_date": "2021-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "NY",
            "license": "198609",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FEDERAL TAX ID#",
            "identifier": "13-4086556",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1840404",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Eileen Frank Markowitz, OCCUPATIONAL THERAPI
• Elizabeth Regina Marsh, M.D.
• Anne- Marie Martin, M.D.
• Paige Anne Martin
• John C Marzano, DPM
• Matias Verna, M.D., PLLC
• Jeanne Matich-Maroney, PHD, LCSW-R
• May Tsui, M.D., PLLC
• Diane May, MPH, MS, RD, CDN
• Clevon McCallum

• Ophthalmology Physician in Scarsdale, NY
• Providers in Scarsdale, NY by specialty
• Ophthalmology Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.