Individual provider Active NPI

Krysta Richelle Mathis, PA

  • Physician Assistant
  • Lubbock, TX
National Provider Identifier
1922736677
Registry record updated Oct 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA18879 Issued in TX
Practice address
3615 19TH St
Lubbock, TX 79410-1203
Phone
(806) 725-0000
NPI assigned
Aug 10, 2022
Last updated
Oct 22, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA18879 TX Primary

Addresses

Primary practice location

3615 19TH St
Lubbock, TX 79410-1203

Mailing address

3615 19TH St
Lubbock, TX 79410-1203
Phone (806) 725-0000

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
I20250613002910 TX Practitioner - Physician Assistant 8224549522 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hospitalist Medicine Physicians of Texas PLLCGroup PAC ID 3476688318, 685 clinicians

Practice addresses (Care Compare)

18951 N Memorial Dr
Humble, TX 77338-4217
Phone (281) 319-8409

2600 Saint Michael Dr
Texarkana, TX 75503-5220
Phone (903) 614-5110

3615 19TH St
Lubbock, TX 79410-1203
Phone (806) 725-0000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA18879TXMDPhysician Assistant

Organizations & group practices 1

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.

Hospital & facility affiliations 4

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

NPI Registry JSON

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

{
    "created_epoch": "1660089600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761091200000",
    "number": "1922736677",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3615 19TH ST",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794101203",
            "telephone_number": "806-725-0000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3615 19TH ST",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794101203",
            "telephone_number": "806-725-0000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATHIS",
        "first_name": "KRYSTA",
        "middle_name": "RICHELLE",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-10",
        "last_updated": "2025-10-22",
        "certification_date": "2025-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA18879",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lubbock, TX

Sources for this page

Verify at the official NPI Registry.