Jatin R Matta, PA-C, MPAS

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

C0002229 Issued in MD

Practice address

1450 Mercantile LN
Suite 217
Largo, MD 20774-5376

Phone

(301) 583-7770

Fax

(301) 583-9414

NPI assigned

Jun 9, 2011

Sex

Male

Sole proprietor

Yes

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 DC

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jrajmatta@cmcl-md.direct.office.nextgen.com
• FHIR API: https://api.platform.athenahealth.com/3119/brand/1/csg/1/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.

• Comprehensive Medical Care, LLC

  • Internal Medicine Physician
  • Silver Spring, MD
  • NPI 1730502816

  DC

  Medicare reassignment
• Husna R Baksh MD PC

  • Internal Medicine Physician
  • Silver Spring, MD
  • NPI 1265577118
  NPD

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

{
    "created_epoch": "1307577600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1307577600000",
    "number": "1316232135",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16831 HARBOUR TOWN DR",
            "city": "SILVER SPRING",
            "state": "MD",
            "postal_code": "209054021",
            "telephone_number": "301-476-9226"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1450 MERCANTILE LN",
            "address_2": "SUITE 217",
            "city": "LARGO",
            "state": "MD",
            "postal_code": "207745376",
            "telephone_number": "301-583-7770",
            "fax_number": "301-583-9414"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATTA",
        "first_name": "JATIN",
        "middle_name": "R",
        "name_prefix": "Mr.",
        "credential": "PA-C, MPAS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-06-09",
        "last_updated": "2011-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MD",
            "license": "C0002229",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "DC",
            "license": "PA30146",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marcos S Faltamo Crna PC
• Makayla Dominique Marshall
• Maryland Oncology Hematology, P.a.
• Charles L. Mason
• Kakneka D Mason, PHARM.D.
• Earl John D Mauricio, M.D.
• May Thu Thu Maw, MBBS, MPH
• Yvonne Abonge Mba, PMHNP
• Rokhaya Mbaye, NP
• Kenneth McAuliffe

• Physician Assistant in Largo, MD
• Providers in Largo, MD by specialty
• Physician Assistant in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2011; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.