Individual provider Active NPI

Sabrina Matovich, PA-C

  • Physician Assistant
  • Houston, TX
National Provider Identifier
1124595939
Registry record updated Sep 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA11888 Issued in TX
Practice address
6410 Fannin St Ste 350
Houston, TX 77030-3004
Phone
(832) 325-7173
NPI assigned
Oct 30, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 5, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA11888 TX Primary

Addresses

Primary practice location

6410 Fannin St Ste 350
Houston, TX 77030-3004

Mailing address

21314 Willowford Park Dr
Katy, TX 77450-5447
Phone (832) 715-8768

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
I20190131000637 TX Practitioner - Physician Assistant 7012254915 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA11888TXMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Ut Physicians CurrentSince Dec 13, 2018 Accepting new patients
Ut Physicians Physician Assistant CurrentSince Dec 13, 2018 Accepting new patients

Locations

6410 Fannin St
Ste 250
Houston, TX 77030
Phone (713) 500-4360

6410 Fannin St
Ste 500
Houston, TX 77030
Phone (713) 500-5714

6410 Fannin St
Ste 350
Houston, TX 77030
Phone (832) 325-7200

Interoperability endpoints

  • Direct secure messaging: smatovich14492@direct.uth.org

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1540857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725494400000",
    "number": "1124595939",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21314 WILLOWFORD PARK DR",
            "city": "KATY",
            "state": "TX",
            "postal_code": "774505447",
            "telephone_number": "832-715-8768"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6410 FANNIN ST STE 350",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770303004",
            "telephone_number": "832-325-7173"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATOVICH",
        "first_name": "SABRINA",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-10-30",
        "last_updated": "2024-09-05",
        "certification_date": "2024-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA11888",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.