Individual provider Active NPI

Matthew Tassinari

  • Medical Physician Assistant
  • Tyler, TX
National Provider Identifier
1033517958
Registry record updated Sep 17, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA09423 Issued in TX
Practice address
2208 Three Lakes Pkwy Ste 200
Tyler, TX 75703-0538
Phone
(903) 596-3844
Fax
(903) 596-3843
NPI assigned
Dec 9, 2014
Last updated
Sep 17, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA09423 TX Primary

Addresses

Primary practice location

2208 Three Lakes Pkwy Ste 200
Tyler, TX 75703-0538

Mailing address

2208 Three Lakes Pkwy Ste 200
Tyler, TX 75703-0538
Phone (903) 596-3844

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170720000113 TX Practitioner - Physician Assistant 6002186350 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Texas Tech University Health Science Center School of Medicine, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Etmc Physician Group, Inc.Group PAC ID 4486915600, 375 clinicians

Practice addresses (Care Compare)

700 Olympic Plaza Cir
Suite 600
Tyler, TX 75701-1954
Phone (903) 596-3844

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA09423TXMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Etmc Physician Group Inc. CurrentSince Feb 1, 2026 Accepting new patients
Etmc Physician Group Inc. CurrentSince Feb 1, 2026 Accepting new patients

Locations

18118 FM 344 W
Flint, TX 75762
Phone (903) 825-3292

1000 S Beckham Ave
Tyler, TX 75701
Phone (903) 526-1068

700 Olympic Plaza Cir
Ste 600
Tyler, TX 75701
Phone (903) 594-2666

Organizations & group practices 3

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

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1418083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1789603200000",
    "number": "1033517958",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2208 THREE LAKES PKWY STE 200",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757030538",
            "telephone_number": "903-596-3844",
            "fax_number": "903-596-3843"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2208 THREE LAKES PKWY STE 200",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757030538",
            "telephone_number": "903-596-3844",
            "fax_number": "903-596-3843"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TASSINARI",
        "first_name": "MATTHEW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-12-09",
        "last_updated": "2026-09-17",
        "certification_date": "2026-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "TX",
            "license": "PA09423",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tyler, TX

Sources for this page

Verify at the official NPI Registry.