Jennifer Garcia Mata, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA06031 Issued in TX

Practice address

6161 N State Highway 161
Irving, TX 75038

Phone

(972) 258-7499

Fax

(972) 257-0897

NPI assigned

Apr 6, 2010

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Jun 6, 2024 through Jun 6, 2028

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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

{
    "created_epoch": "1270512000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1535068800000",
    "number": "1316262033",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6161 N STATE HIGHWAY 161",
            "city": "IRVING",
            "state": "TX",
            "postal_code": "750382220",
            "telephone_number": "972-258-7499",
            "fax_number": "972-257-0897"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6161 N STATE HIGHWAY 161",
            "city": "IRVING",
            "state": "TX",
            "postal_code": "75038",
            "telephone_number": "972-258-7499",
            "fax_number": "972-257-0897"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATA",
        "first_name": "JENNIFER",
        "middle_name": "GARCIA",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-04-06",
        "last_updated": "2018-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA06031",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TXB109485",
            "identifier": "1319262033",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Dipak Master, O.D.
• Vimi Ketan Masters, PA-C
• Sherry Lynnette Masterson, PA-C
• Aditi Masurkar, MSOT, OTR/L
• Alexandra Katherine Mata, PTA
• Lejoy Mathew, DPT
• Renjan Roy Mathew, PH.D.
• Shauna Mathew, FNP
• Smitha Mathew
• Stanley Mathew, FNP-C

• Physician Assistant in Irving, TX
• Providers in Irving, TX by specialty
• Physician Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2018; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.