Individual provider Active NPI

Matthew Jakob Kozera

  • Physical Therapy Assistant
  • Odessa, TX
National Provider Identifier
1871424838
Registry record updated Jul 23, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
2188413 Issued in TX
Practice address
5000 Hanover Dr
Odessa, TX 79761-2239
Phone
(432) 550-4700
NPI assigned
May 28, 2026
Last updated
Jul 23, 2026By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 23, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 2188413 TX Primary

Addresses

Primary practice location

5000 Hanover Dr
Odessa, TX 79761-2239

Mailing address

5000 Hanover Dr
Odessa, TX 79761-2239

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
4063908TXMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1779926400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784764800000",
    "number": "1871424838",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5000 HANOVER DR",
            "city": "ODESSA",
            "state": "TX",
            "postal_code": "797612239"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5000 HANOVER DR",
            "city": "ODESSA",
            "state": "TX",
            "postal_code": "797612239",
            "telephone_number": "432-550-4700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOZERA",
        "first_name": "MATTHEW",
        "middle_name": "JAKOB",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2026-05-28",
        "last_updated": "2026-07-23",
        "certification_date": "2026-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "TX",
            "license": "2188413",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Odessa, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.