Nitchelle Aidee Rodriguez Mata, PA-C

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

PA15602 Issued in TX

Practice address

208 Starr St
Mercedes, TX 78570-2734

Phone

(956) 514-1643

NPI assigned

Apr 20, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Mid Valley Adult Specialists PA

  • Internal Medicine Physician
  • Weslaco, TX
  • NPI 1104009513
  NPD (past)
• Rio Grande Valley Adult & Internal Medicine Specialists PLLC

  • Internal Medicine Physician
  • Weslaco, TX
  • NPI 1528039120
  NPD (past)

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

{
    "created_epoch": "1650412800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650412800000",
    "number": "1174266795",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3004 S L ST APT 2",
            "city": "MCALLEN",
            "state": "TX",
            "postal_code": "785031903",
            "telephone_number": "956-388-0443"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "208 STARR ST",
            "city": "MERCEDES",
            "state": "TX",
            "postal_code": "785702734",
            "telephone_number": "956-514-1643"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ MATA",
        "first_name": "NITCHELLE",
        "middle_name": "AIDEE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-04-20",
        "last_updated": "2022-04-20",
        "certification_date": "2022-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "PA15602",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "PA15602",
            "state": "TX"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://www.rgvadultmedicine.com/",
            "affiliation": "Y",
            "endpointDescription": "Rio Grande Valley Adult & Internal Medicine Specialists",
            "affiliationName": "Rio Grande Valley Adult & Internal Medicine Specialists PLLC",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1010 James St",
            "city": "Weslaco",
            "state": "TX",
            "country_code": "US",
            "postal_code": "785966654",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Nora Lisa Rivas, OTR
• River Health Care LLC
• River Healthcare II LLC
• Felix Rocha Jr., SLP-ASSISTANT
• Jose Rocha III
• Amanda Rodriguez
• Amanda Michelle Rodriguez
• Kassidie Faith Rodriguez
• Sandra Rodriguez, PA-C
• Alyssa Andrea Romero

• Pediatrics Physician in Mercedes, TX
• Providers in Mercedes, TX by specialty
• Pediatrics Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.