Matthew N Mastrodicasa, MD

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

License

BP10083961 Issued in TX

Practice address

11130 Christus Hills
Medical Plaza 3, 3Rd Floor
San Antonio, TX 78251-3585

Phone

(210) 703-9001

Fax

(210) 703-9155

NPI assigned

Apr 19, 2023

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Interoperability endpoints

• Direct secure messaging: mmastrodicasa316688@christushealth.direct-ci.net

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

{
    "created_epoch": "1681862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681862400000",
    "number": "1720775992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11130 CHRISTUS HILLS",
            "address_2": "MEDICAL PLAZA 3, 3RD FLOOR",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782513585",
            "telephone_number": "210-703-9001",
            "fax_number": "210-703-9155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11130 CHRISTUS HILLS",
            "address_2": "MEDICAL PLAZA 3, 3RD FLOOR",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782513585",
            "telephone_number": "210-703-9001",
            "fax_number": "210-703-9155"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MASTRODICASA",
        "first_name": "MATTHEW",
        "middle_name": "N",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-04-19",
        "last_updated": "2023-04-19",
        "certification_date": "2023-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "TX",
            "license": "BP10083961",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David Haynes Masters, DDS
• Lisa B. Masters, DDS, MS
• Patrick A Masters, M.D.
• Michelle Renea Maston, PTA
• Nichole Lynn Mastro, MD
• John David Mastrovich, M.D.
• Rebecca Mastrovich
• Saad Masud, MD
• Masvida Health Care Solutions, LLC
• Gary J Maszak, MD

• Student in an Organized Health Care Education/Training Program in San Antonio, TX
• Providers in San Antonio, TX by specialty
• Student in an Organized Health Care Education/Training Program in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2023; 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.