Individual provider Active NPI

Natalie Angele Mattos, PA

  • Medical Physician Assistant
  • Modesto, CA
National Provider Identifier
1265415525
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA18095 Issued in CA
Practice address
1114 6TH St
Modesto, CA 95354-2203
Phone
(209) 576-2845
Fax
(209) 236-1290
NPI assigned
Nov 21, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 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 PA18095 CA Primary

Addresses

Primary practice location

1114 6TH St
Modesto, CA 95354-2203

Mailing address

PO Box 2906
Turlock, CA 95381-2906
Phone (209) 892-3111

Other identifiers 1

IdentifierTypeStateIssuer
1069551OtherCANCCPA CERT #

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20160426001544 CA Practitioner - Physician Assistant 6901826007 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Modesto Urgent Care IncGroup PAC ID 2163558669, 2 clinicians

Practice addresses (Care Compare)

3440 McHenry Ave
Suite D6
Modesto, CA 95350-1469
Phone (209) 529-1524

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA18095CAMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Turlock Urgent Care Past Accepting new patients

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": "1132531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1265415525",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2906",
            "city": "TURLOCK",
            "state": "CA",
            "postal_code": "953812906",
            "telephone_number": "209-892-3111",
            "fax_number": "209-892-3112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1114 6TH ST",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953542203",
            "telephone_number": "209-576-2845",
            "fax_number": "209-236-1290"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATTOS",
        "first_name": "NATALIE",
        "middle_name": "ANGELE",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-21",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": "PA18095",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCCPA CERT #",
            "identifier": "1069551",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Modesto, CA

Sources for this page

Verify at the official NPI Registry.