Haylie Ashtyn Mata
Individual provider Active NPI Family Nurse Practitioner · Boswell, OK
NPI 1992525976 · NPPES record last updated Oct 14, 2024
Key facts
- NPI
- 1992525976
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 220582 (OK)
- Practice address
- 50 E 2040 Rd
Boswell, OK 74727-9385 - Phone
- (580) 920-5870
- NPI assigned
- Oct 14, 2024
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 10
Hospital & facility affiliations 3
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2024
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Durant Hma Physician Management LLC
Marshall County Hma, LLC
Practice addresses (Care Compare)
1592 S Virginia Ave
Atoka, OK 74525-3246
Phone (580) 889-6621
1610 W University Blvd
Durant, OK 74701-3096
Phone (580) 924-3400
Hospital & facility affiliations
- Alliancehealth Madill
- Alliancehealth Durant
- Atoka County Medical Center
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OK
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20250125000135 | OK | Practitioner - Nurse Practitioner | 6901335637 | Reassigns benefits to 3 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Marshall County Hma LLC | Current |
Accepting new patients | |
| Durant Hma Physician Management, LLC | Current |
Accepting new patients | |
| Breedlove Wound Care of Oklahoma LLC | Current |
Accepting new patients | |
| Marshall County Hma, LLC | Current |
Accepting new patients | |
| OB/GYN Associates of Durant | Past | Accepting new patients | |
| Marshall County Hma, LLC | Past | Accepting new patients |
Locations
1592 S Virginia Ave
Atoka, OK 74525
Phone (580) 889-3355
1400 Bryan Dr
Ste 301
Durant, OK 74701
Phone (580) 920-0105
119 E Jackson St
#A
Hugo, OK 74743
Phone (903) 947-2020
907 Hospital Dr
Madill, OK 73446
Phone (580) 795-0191
Interoperability endpoints
- haylie.mata.1@4696.direct.athenahealth.com
- haylie.mata.2@4696.direct.athenahealth.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 220582 | OK | Yes |
Addresses
Primary practice location
50 E 2040 Rd
Boswell, OK 74727-9385
Mailing address
50 E 2040 Rd
Boswell, OK 74727-9385
Phone (580) 920-5870
Other names
- Haylie Ashtyn McGowan
Other providers in Boswell, OK
- Amelia Gayle Lee
- Boswell Public Schools
- Jesse Michael Farmer Sr.
- Jodie H Moore
- Julie Palmer
- Pushmataha Family Medical Center Inc
- Ashley Smallwood
- Amanda Lyn Vandenburg
All providers in Boswell, OK · Family Nurse Practitioner in Oklahoma
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 14, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.