NPIMap

Organization Active NPI

Discovery Medical Network Matagorda LLC

Doing business as Matagorda Medical Group

  • Family Medicine Physician
  • Bay City, TX
National Provider Identifier
1053672535
Registry record updated May 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
DISCOVERY MEDICAL NETWORK MATAGORDA LLC
Doing business as
Matagorda Medical Group
Practice address
600 Hospital Cir
Bay City, TX 77414-4771
Phone
(979) 245-0001
Fax
(979) 244-8103
NPI assigned
May 31, 2012
Last updated
May 13, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
DISCOVERY MEDICAL NETWORK INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on May 13, 2024

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

Authorized official

Name
Ms. JJ Webb
Title
Administrator
Phone
(806) 776-0607

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary
Pediatrics PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208000000X
Urology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208800000X
Rural Health Clinic/Center 261QR1300X

Addresses

Primary practice location

600 Hospital Cir
Bay City, TX 77414-4771

Mailing address

1500 Broadway Ste 1000
Lubbock, TX 79401-3179
Phone (806) 791-1591

Other practice location 1

1413 Avenue G
Bay City, TX 77414-4730
Phone (979) 241-3457

Other names 1

  • Matagorda Medical Group Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20120910000288 TX Part B Supplier - Clinic/Group Practice 4082862487 Receives reassigned benefits from 28 practitioners
Practice locations: Bay City, TX
O20180626001955 TX Part A Provider - Rural Health Clinic 4082862487 1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Bay City, TX

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1053672535. Details of each certification follow.

Rural health clinic certification: CCN 673947

Legal name
DISCOVERY MEDICAL NETWORK MATAGORDA LLC
Doing business as
MATAGORDA MEDICAL GROUP
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Jul 29, 2019
Last certification
Jul 17, 2025
Ownership / control type
1B
Organization structure
LLCProprietary
Enrollment address
600 Hospital Cir
Bay City, TX 77414-4771

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Part of
Discovery Medical Network I

Locations

600 Hospital Cir
Ste 100
Bay City, TX 77414
Phone (979) 241-6100

600 Hospital Cir
Ste 200
Bay City, TX 77414
Phone (979) 244-1374

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/5673/brand/1/csg/1/fhir/r4

Ownership & related parties

All disclosed owners & managing parties 4

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Discovery Medical Network, Inc Organization, Lubbock, TX For-profit 5% Or Greater Direct Ownership Interest May 1, 2018 100%
Operational/Managerial Control May 1, 2018
Michael Yost Individual Corporate DirectorVice President May 1, 2015
Gail Bass Individual W-2 Managing EmployeeBusiness Office Supervisor May 1, 2018
Jacqueline Webb Individual Corporate DirectorAdministration Jan 1, 2024

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 30

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 30

NPI Registry JSON

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

{
    "created_epoch": "1338422400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1715558400000",
    "number": "1053672535",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 BROADWAY STE 1000",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794013179",
            "telephone_number": "806-791-1591"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 HOSPITAL CIR",
            "city": "BAY CITY",
            "state": "TX",
            "postal_code": "774144771",
            "telephone_number": "979-245-0001",
            "fax_number": "979-244-8103"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1413 Avenue G",
            "address_purpose": "LOCATION",
            "city": "Bay City",
            "state": "TX",
            "postal_code": "774144730",
            "country_code": "US",
            "telephone_number": "979-241-3457",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "DISCOVERY MEDICAL NETWORK MATAGORDA LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "DISCOVERY MEDICAL NETWORK INC.",
        "enumeration_date": "2012-05-31",
        "last_updated": "2024-05-13",
        "certification_date": "2024-05-13",
        "status": "A",
        "authorized_official_last_name": "WEBB",
        "authorized_official_first_name": "JJ",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "806-776-0607",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208800000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Urology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Matagorda Medical Group",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Matagorda Medical Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bay City, TX

Sources for this page

Verify at the official NPI Registry.