B Mata LLC

Primary specialty

Geriatric Medicine (Family Medicine) PhysicianTaxonomy code 207QG0300X

Legal business name

B MATA LLC

Practice address

1631 Atlanta Hwy
Gainesville, GA 30504-5942

Phone

(770) 718-1517

Fax

(770) 718-1518

NPI assigned

Jan 28, 2020

Organization subpart

No

Name

Byron Oswaldo Mata Gonzalez, MDNPI 1326206897

Title

Owner

Phone

(786) 427-4450

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

• Leodez

  • General Practice Physician
  • Tucker, GA
  • NPI 1255933115
  NPPES parent name

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Byron Oswaldo Mata Gonzalez

  • Hospitalist Physician
  • Gainesville, GA
  • NPI 1326206897

  Geriatric Medicine

  NPD Authorized official

• Centro Medico San Lucas Doing business as

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jan 28, 2020.

{
    "created_epoch": "1580169600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1580169600000",
    "number": "1295366292",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1631 ATLANTA HWY",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305045942",
            "telephone_number": "770-718-1517",
            "fax_number": "770-718-1518"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1631 ATLANTA HWY",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305045942",
            "telephone_number": "770-718-1517",
            "fax_number": "770-718-1518"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4292 Chamblee Tucker Rd",
            "address_purpose": "LOCATION",
            "city": "Tucker",
            "state": "GA",
            "postal_code": "300842103",
            "country_code": "US",
            "telephone_number": "770-718-1517 x2",
            "fax_number": "770-718-1518",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "B MATA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-01-28",
        "last_updated": "2020-01-28",
        "certification_date": "2020-01-28",
        "status": "A",
        "authorized_official_last_name": "MATA GONZALEZ",
        "authorized_official_first_name": "BYRON",
        "authorized_official_middle_name": "OSWALDO",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "786-427-4450",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207QG0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://npiregistry.cms.hhs.gov/",
            "affiliation": "N",
            "address_1": "1631 Atlanta Hwy",
            "city": "Gainesville",
            "state": "GA",
            "country_code": "US",
            "postal_code": "305045942",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Centro Medico San Lucas",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kristy Aycinena, CSFA
• Didem Deniz Aydin
• Rachel Greene Ayers, LCSW
• Bolaji Olubusayo Ayinde, MD
• Karen L Azar
• Modupeoluwa Babalola
• Jennifer Fayth Babb, PT, DPT
• Lindsey Hood Babcock, OTR/L
• Babies Can'T Wait
• Craig Joseph Baden, MD, MPH

• All providers in Gainesville, GA
• Geriatric Medicine (Family Medicine) Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2020; 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.