Glenda Elizabeth Mata

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

1178177 Issued in TX

Practice address

5502 S McColl Rd
Edinburg, TX 78539-8747

Phone

(956) 362-4451

NPI assigned

Oct 29, 2024

Sex

Female

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: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Children's Physician Services of South Texas

  dba Plastic Reconstructive Surgical Services of South Texas

  • Plastic Surgery Physician
  • Corpus Christi, TX
  • NPI 1568658227
  Medicare reassignment NPD
• We Are Kids at Heart of the Rio Grande Valley, PLLC

  • Physician Assistant
  • Edinburg, TX
  • NPI 1720795149
  Medicare reassignment NPD
• Children's Physician Services of South Texas

  • Pediatrics Physician
  • Corpus Christi, TX
  • NPI 1801856786
  NPD
• Children's Physician Services of South Texas

  dba Children's Radiology Services of South Texas

  • Diagnostic Radiology Physician
  • Corpus Christi, TX
  • NPI 1598737124
  NPD (past)

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

{
    "created_epoch": "1730160000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730160000000",
    "number": "1801618996",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3510 N 40TH LN",
            "city": "MCALLEN",
            "state": "TX",
            "postal_code": "785013307",
            "telephone_number": "956-336-7412"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5502 S MCCOLL RD",
            "city": "EDINBURG",
            "state": "TX",
            "postal_code": "785398747",
            "telephone_number": "956-362-4451"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "922 S Closner Blvd",
            "address_purpose": "LOCATION",
            "city": "Edinburg",
            "state": "TX",
            "postal_code": "785395609",
            "country_code": "US",
            "telephone_number": "956-381-8431",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MATA",
        "first_name": "GLENDA",
        "middle_name": "ELIZABETH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-10-29",
        "last_updated": "2024-10-29",
        "certification_date": "2024-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "TX",
            "license": "1178177",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mariana Kassandra Mascorro, SLP
• Christina Masso, RBT
• Masvida Health Care Solutions LLC (JMeds)
• Maria Mata Merinas
• Angelica Mata, APRN
• Llayra Monserrat Mata, RBT
• Angelica Yolanda Matamoros, LCDC
• Raymundo G Matar, MD
• David Antonio Mateo de Acosta Andino, M.D.
• Rajeev K Mathavan, MD

• Pediatric Nurse Practitioner in Edinburg, TX
• Providers in Edinburg, TX by specialty
• Pediatric Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 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.