Individual provider Active NPI

Haley Mattiza

  • Gerontology Nurse Practitioner
  • Houston, TX
National Provider Identifier
1356005219
Registry record updated Oct 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
AP142358 Issued in TX
Practice address
10318 Lake Rd Ste 102
Houston, TX 77070-1874
Phone
(281) 847-6300
Fax
(281) 847-6301
NPI assigned
Oct 27, 2021
Last updated
Oct 27, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 27, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X AP142358 TX Primary

Addresses

Primary practice location

10318 Lake Rd Ste 102
Houston, TX 77070-1874

Mailing address

12519 Randy Riley Way
Tomball, TX 77377-9134

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20211209001911 TX Practitioner - Nurse Practitioner 1153711916 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
TMH Physician Associates PLLCGroup PAC ID 4486711744, 1,881 clinicians
Houston Methodist Specialty PhysiciansGroup PAC ID 5193239796, 1,498 clinicians

Practice addresses (Care Compare)

16605 Southwest Fwy
Sugar Land, TX 77479-3500
Phone (281) 275-0800

16605 Southwest Fwy 400 Mob3
Methodist Family Medicine Group
Sugar Land, TX 77479-3500
Phone (281) 275-0800

16605 SW Fwy 410
Methodist Diag Card of Houston
Sugar Land, TX 77479-3500
Phone (281) 274-0148

16655 Southwest Fwy
Sugar Land, TX 77479-2329

16811 Southwest Fwy
Suite 200
Sugar Land, TX 77479-4728
Phone (281) 690-4678

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
AP142358TXMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
TMH Physician Associates PLLC CurrentSince Jun 2, 2025 Accepting new patients
TMH Physician Associates PLLC CurrentSince Jun 2, 2025 Accepting new patients
Houston Methodist Specialty Physicians CurrentSince Jan 1, 2026 Accepting new patients
Seasons Hospice & Palliative Care of Texas, Inc PastSince Nov 8, 2021 Accepting new patients
TMH Physician Associates PLLC Past Accepting new patients

Locations

6565 Fannin St
#623
Houston, TX 77030
Phone (713) 363-8584

16605 Southwest Fwy
Ste 400
Sugar Land, TX 77479
Phone (281) 275-0800

16655 Southwest Fwy
Sugar Land, TX 77479
Phone (281) 274-7117

16811 Southwest Fwy
Ste 200
Sugar Land, TX 77479
Phone (281) 690-4678

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1635292800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635292800000",
    "number": "1356005219",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12519 RANDY RILEY WAY",
            "city": "TOMBALL",
            "state": "TX",
            "postal_code": "773779134"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10318 LAKE RD STE 102",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770701874",
            "telephone_number": "281-847-6300",
            "fax_number": "281-847-6301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATTIZA",
        "first_name": "HALEY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-10-27",
        "last_updated": "2021-10-27",
        "certification_date": "2021-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "TX",
            "license": "AP142358",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.