Velma Mata, P.A.-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

2001003695 Issued in MO

Practice address

Highway 61 S
Crystal City, MO 63019

Phone

(636) 933-1000

NPI assigned

Sep 20, 2006

Last updated

Feb 8, 2008By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

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.

• Saint Anthony's Physician Group

  • Internal Medicine Physician
  • Alton, IL
  • NPI 1750497319
  NPD (past)
• Saint Anthonys Health Center

  • General Acute Care Hospital
  • Alton, IL
  • NPI 1528079027
  NPD (past)

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1202428800000",
    "number": "1457459281",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "75 REMIT DRIVE",
            "address_2": "LOCKBOX 1131",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606751131",
            "telephone_number": "866-916-5259",
            "fax_number": "231-922-4060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "HIGHWAY 61 S",
            "city": "CRYSTAL CITY",
            "state": "MO",
            "postal_code": "63019",
            "telephone_number": "636-933-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATA",
        "first_name": "VELMA",
        "credential": "P.A.-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-20",
        "last_updated": "2008-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MO",
            "license": "2001003695",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "85002144",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MO",
            "license": "2000166686",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kristel Cherisse Kronk, MS, CCC-SLP
• Jung Hun Lee, M.D.
• Brian Lenz, MD
• Laura L Lukowski, LCSW
• Rodolfo Maceren, MD
• Elena Luisa May-Plaza, APRN
• Peter McCarthy, MD
• Julie Lynn McDowell, LPC
• Medical West Respiratory Services, LLC
• Camran Mehrsheikh

• Physician Assistant in Crystal City, MO
• Providers in Crystal City, MO by specialty
• Physician Assistant in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2008; 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.