Jaya Matharage, MSN

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

1091862 Issued in TX

Practice address

3604 Nandina Dr
Flower Mound, TX 75022-1018

Phone

(972) 859-9565

NPI assigned

Sep 16, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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

Specialty

Nurse Practitioner

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Immanuel Family Clinic PLLCGroup PAC ID 5698101517, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science - Nursing, Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

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.

• Immanuel Family Clinic PLLC

  • Family Nurse Practitioner
  • Carrollton, TX
  • NPI 1265072490
  Medicare reassignment Care Compare group NPD
• Jalil a Khan, MD, PA

  dba Pri-Med Care

  • Internal Medicine Physician
  • Lewisville, TX
  • NPI 1255424859
  Medicare reassignment NPD

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

{
    "created_epoch": "1663286400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663286400000",
    "number": "1205558251",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3604 NANDINA DR",
            "city": "FLOWER MOUND",
            "state": "TX",
            "postal_code": "750221018",
            "telephone_number": "972-859-9565"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3604 NANDINA DR",
            "city": "FLOWER MOUND",
            "state": "TX",
            "postal_code": "750221018",
            "telephone_number": "972-859-9565"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATHARAGE",
        "first_name": "JAYA",
        "credential": "MSN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-09-16",
        "last_updated": "2022-09-16",
        "certification_date": "2022-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WR0400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Rehabilitation",
            "state": "TX",
            "license": "944753",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "1091862",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Molly Mason, RBT-24-324135
• Shane Michael Mason, D.D.S.
• Julianna Masonheimer, PA-C
• Mata Counseling Services PLLC
• Rebeca Mata, M.ED., LPC-S
• Angie Maupin, SLP
• Maximacare LLC (Arcy Home Health)
• Mayfield Wellness, PLLC
• Dixie L. Mayfield, D.C.
• Heidi McBain

• Family Nurse Practitioner in Flower Mound, TX
• Providers in Flower Mound, TX by specialty
• Family Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.