Individual provider Active NPI

Isaias Mata Jr., P.A.

  • Medical Physician Assistant
  • Houston, TX
National Provider Identifier
1780865857
Registry record updated May 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA03404 Issued in TX
Practice address
7877 Willow Chase Blvd
Houston, TX 77070-5934
Phone
(832) 869-4818
Fax
(832) 241-2902
NPI assigned
Nov 16, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 1, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA03404 TX Primary

Addresses

Primary practice location

7877 Willow Chase Blvd
Houston, TX 77070-5934

Mailing address

2717 Michael Angelo
Edinburg, TX 78539-1403
Phone (956) 217-7000

Other practice location 1

2717 Michael Angelo
Edinburg, TX 78539-1403
Phone (956) 217-7000

Other identifiers 1

IdentifierTypeStateIssuer
PA03404OtherTXTEXAS LICENSE

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
I20040306000197 TX Practitioner - Physician Assistant 2769370238 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
South Texas Clinic for Pain ManagementGroup PAC ID 5991776809, 3 clinicians

Practice addresses (Care Compare)

4770 N Expressway
83 Suite 103
Brownsville, TX 78520
Phone (956) 687-8120

5505 S Expressway
77 Suite 106
Harlingen, TX 78550-3223
Phone (956) 423-9996

801 E Nolana Ave
McAllen, TX 78504-6113

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA03404TXMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
McAllen Hospitalist Group, PLLC PastSince Jan 2, 2017 Accepting new patients
Jorge Zamora-Quezada MD MPH PA Past Accepting new patients
Jorge a Ortegon MD PA Past Accepting new patients

Organizations & group practices 6

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

NPI Registry JSON

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

{
    "created_epoch": "1195171200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714521600000",
    "number": "1780865857",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2717 MICHAEL ANGELO",
            "city": "EDINBURG",
            "state": "TX",
            "postal_code": "785391403",
            "telephone_number": "956-217-7000",
            "fax_number": "956-682-1960"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7877 WILLOW CHASE BLVD",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770705934",
            "telephone_number": "832-869-4818",
            "fax_number": "832-241-2902"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2717 Michael Angelo",
            "address_purpose": "LOCATION",
            "city": "Edinburg",
            "state": "TX",
            "postal_code": "785391403",
            "country_code": "US",
            "telephone_number": "956-217-7000",
            "fax_number": "956-682-1960",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MATA",
        "first_name": "ISAIAS",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "P.A.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-11-16",
        "last_updated": "2024-05-01",
        "certification_date": "2024-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "TX",
            "license": "PA03404",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TEXAS LICENSE",
            "identifier": "PA03404",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.