Heather Lynne Mata, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

10001212A Issued in IN

Practice address

3495 S 4TH St
Terre Haute, IN 47802-5501

Phone

(812) 220-4755

Fax

(812) 231-4475

NPI assigned

May 24, 2006

Last updated

Apr 9, 2024By 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 2

Addresses

Medicare fee-for-service enrollment

Enrolled in IN

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

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: heather.mata.1@23284.direct.athenahealth.com

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.

• Proactive Mso, LLC

  dba Proactive MD Terre Haute Health Center

  • Primary Care Clinic/Center
  • Terre Haute, IN
  • NPI 1972011815
  NPD

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

{
    "created_epoch": "1148428800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712620800000",
    "number": "1518912971",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3495 S 4TH ST",
            "city": "TERRE HAUTE",
            "state": "IN",
            "postal_code": "478025501",
            "telephone_number": "812-220-4755",
            "fax_number": "812-231-4475"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3495 S 4TH ST",
            "city": "TERRE HAUTE",
            "state": "IN",
            "postal_code": "478025501",
            "telephone_number": "812-220-4755",
            "fax_number": "812-231-4475"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATA",
        "first_name": "HEATHER",
        "middle_name": "LYNNE",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-24",
        "last_updated": "2024-04-09",
        "certification_date": "2024-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "IN",
            "license": "10001212A",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601002771",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jamie Mason, PHARMD
• Laura Mason, OTR/L
• Sabrina Mason
• Kenneth R Massey, PAC
• John R Mast, D.D.S.
• Ashley P Matchett, PT
• Jasmine Mathew
• Jessica Mathew
• Sherryl Mary Mathew, DDS
• Andrew Mathis, PA-C

• Medical Physician Assistant in Terre Haute, IN
• Providers in Terre Haute, IN by specialty
• Medical Physician Assistant in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2024; 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.