JACK M II MATHENY – Family Medicine Physician, NPI 1629040043
Family Medicine Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for JACK M II MATHENY
Zeagler Drive, Palatka, Putnam County, Florida, 32177, United States
PALATKA, FL 321773826
Phone: (386) 328-6746
Fax: (386) 328-7554
Mailing address matches the actual address.
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 155 Open Payments records for all available years, with a total value of $2,794.
Total Amount is formed as General ($2,794) + Research ($0) + Ownership ($0) = $2,794.
Last reported payment date: 2024-12-13 • Largest payer in this snapshot: Lilly USA, LLC ($759).
Total Amount
$2,794
General + Research + Ownership
Payments
155
Total payment records
General Amount
$2,794
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-13
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Lilly USA, LLC | $759 |
| ABBVIE INC. | $511 |
| AstraZeneca Pharmaceuticals LP | $483 |
| IDORSIA PHARMACEUTICALS US INC | $99 |
| PFIZER INC. | $93 |
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2011-01-04
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Past revalidation due date
Earliest CMS due date was 2024-06-30 (708 days ago).
Enrollment records
2
Earliest due date
2024-06-30
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20101202001288 | I | Family Practice | FL | TBD |
| O20110104000382 | O | Rural Health Clinic | FL | 2024-06-30 |
What to do next
- Verify current status on the CMS Revalidation Lookup Tool immediately.
- Complete revalidation in PECOS or contact your Medicare Administrative Contractor (MAC).
- Overdue revalidation can lead to deactivation of Medicare billing privileges.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 637 | 369 | $0 |
| G0439 | Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit | 328 | 328 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 211 | 171 | $0 |
| G0444 | Annual depression screening, 5 to 15 minutes | 64 | 64 | $0 |
| 99495 | Transitional care management services for problem of at least moderate complexity | 32 | 28 | $0 |
Insurance plans in this area (ZIP 32177)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| FAMILY MEDICINE | FL | 93010 | Routine electrocardiogram (EKG) using at least 12 leads with interpretation and report | 52 | 52 |
| FAMILY MEDICINE | FL | 94060 | Measurement and graphic recording of the amount and speed of breathed air, before and following medication administration | 27 | 27 |
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