JACK M MATHENY NPI 1629040043

NPI Information

  • NPI: 1629040043
  • Provider Name: JACK M MATHENY
  • Classification: Family Medicine - 207Q00000X
  • Entity Type: Individual
  • PECOS Registration: Yes
  • CLIA Number: 10D0268245
  • Address: 700 ZEAGLER DR STE 10
    PALATKA, FL
    ZIP 32177
  • Phone: (386) 328-6746

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NPI Details

Jack M Matheny is a family medicine in Palatka, FL with 50 years of experience. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. Jack M Matheny NPI is 1629040043. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: WEST VIRGINIA UNIVERSITY SCHOOL OF MEDICINE
Graduation Year:1975

The provider's business location address is:

700 ZEAGLER DR STE 10
PALATKA, FL
ZIP 32177-826
Phone: (386) 328-6746
Fax: (386) 328-7554

The NPI 1629040043 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The CLIA number assigned to this NPI record is 10D0268245 - physician office with a certificate type of Certificate of Waiver.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Established patient office or other outpatient visit, 30-39 minutes (HCPCS:99214)
  • Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit (HCPCS:G0439)
  • Annual depression screening, 15 minutes (HCPCS:G0444)
  • Established patient office or other outpatient visit, 20-29 minutes (HCPCS:99213)
  • Advance care planning, first 30 minutes (HCPCS:99497)
  • Follow-up nursing facility visit per day, typically 35 minutes (HCPCS:99310)
  • Physician or allowed practitioner certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians and (HCPCS:G0180)
  • Detection test by immunoassay with direct visual observation for severe acute respiratory syndrome coronavirus 2 (covid-19) (HCPCS:87811)
  • Testing for presence of drug, read by direct observation (HCPCS:80305)
  • Transitional care management services for problem of high complexity (HCPCS:99496)
  • New patient office or other outpatient visit, 45-59 minutes (HCPCS:99204)
  • Transitional care management services for problem of moderate complexity (HCPCS:99495)
  • Test to measure expiratory airflow and volume changes before and after medication administration (HCPCS:94060)
  • Test to measure largest amount of air breathed in an out (HCPCS:94200)
  • Evaluation of use of breathing device (HCPCS:94664)
  • Test to determine lung volumes using gas dilution or washout (HCPCS:94727)
  • Test to examine how well the lungs exchange gases (HCPCS:94729)
  • Extended patient service without direct patient contact, first hour (HCPCS:99358)

The enumeration date for this NPI number is 2/2/2006 and was last updated on 4/2/2019.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207Q00000XFamily MedicineME0048571FLORIDAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1372143400OTHERFLORIDAMEDICAID GROUP NUMBER FOR NON RURAL HEALTH SERVICES
2372143401OTHERFLORIDAMEDICAID GROUP NUMBER FOR RURAL HEALTH CLINIC
3046979300MEDICAIDFLORIDA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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