Fidel Mata, P.A.

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

085-002235 Issued in IL

Practice address

1770 E Lake Shore Dr Ste 105
Decatur, IL 62521-3800

Phone

(217) 422-6100

Fax

(833) 784-5326

NPI assigned

Oct 24, 2006

Last updated

Sep 29, 2026By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in IL

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

Specialty

Physician Assistant

Education

Other, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Prairie Cardiovascular Consultants LTDGroup PAC ID 3173435880, 94 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• St Marys Hospital Hospital, Decatur, IL, CCN 140166
• St Johns Hospital Hospital, Springfield, IL, CCN 140053
• HSHS Good Shepherd Hospital Inc Hospital, Shelbyville, IL, CCN 141354

Merit-based Incentive Payment System (MIPS)

Final score

94.81 of 100Reported as apm

Quality

85.98

Promoting interoperability

100

Improvement activities

40

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.

• Prairie Cardiovascular Consultants LTD

  • Multi-Specialty Clinic/Center
  • Springfield, IL
  • NPI 1982714218
  Medicare reassignment Care Compare group
• Prairie Cardiovascular Consultants LTD

  • Cardiovascular Disease Physician
  • Springfield, IL
  • NPI 1659539559
  NPD (past)

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

• HSHS Good Shepherd Hospital Inc

  • Critical Access Hospital
  • Shelbyville, IL
  • NPI 1053348532
  Care Compare affiliation
• St Johns Hospital of the Hospital Sisters of the Third Order of St F

  dba HSHS St. John's Hospital

  • General Acute Care Hospital
  • Springfield, IL
  • NPI 1205818481
  Care Compare affiliation
• St Marys Hospital Decatur of the Hospital Sisters of the Third Order

  dba St Marys Hospital

  • General Acute Care Hospital
  • Decatur, IL
  • NPI 1326041229
  Care Compare affiliation

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

{
    "created_epoch": "1161648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790640000000",
    "number": "1558445924",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1770 E LAKE SHORE DR STE 105",
            "city": "DECATUR",
            "state": "IL",
            "postal_code": "625213800",
            "telephone_number": "217-422-6100",
            "fax_number": "833-784-5326"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1770 E LAKE SHORE DR STE 105",
            "city": "DECATUR",
            "state": "IL",
            "postal_code": "625213800",
            "telephone_number": "217-422-6100",
            "fax_number": "833-784-5326"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1800 E Lake Shore Dr",
            "address_purpose": "LOCATION",
            "city": "Decatur",
            "state": "IL",
            "postal_code": "625213810",
            "country_code": "US",
            "telephone_number": "217-422-6100",
            "fax_number": "217-422-3217",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MATA",
        "first_name": "FIDEL",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-24",
        "last_updated": "2026-09-29",
        "certification_date": "2021-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "IL",
            "license": "085-002235",
            "primary": true
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "IL",
            "license": "085.002235",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "fmata100041@ewd.direct.hshs.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/CCD/TXT",
            "address_1": "1770 E Lake Shore Dr Ste 105",
            "city": "Decatur",
            "state": "IL",
            "country_code": "US",
            "postal_code": "625213800",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Roberta Jo Martin, PHARMD
• Susan K Martin
• Amanda Martz
• Angie Mason, RBT
• Anita F Mason, MA; LMFT
• Wayne Allen Mathews, PAC
• Maggie Kaye Matthews, NP
• Victoria Princess Matthews, FNP
• David Mark Mattiuz, PHARM.D.
• Maxover, LLC (Promax Construction)

• Medical Physician Assistant in Decatur, IL
• Providers in Decatur, IL by specialty
• Medical Physician Assistant in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2026; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.