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THELICIA MATA APRN-CNP
NPI 1063391845
Nurse Practitioner - Acute Care in San Antonio, TX

Active since August 27, 2025PECOS EnrolledAccepts Medicare Assignment
4502 MEDICAL DR, SAN ANTONIO, TX 78229(210) 743-0670(210) 567-4659 Get Directions Write a Review

NPPES record last updated: November 4, 2025. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Thelicia Mata Aprn-cnp NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

THELICIA MATA APRN-CNP (NPI 1063391845) is an individual acute care provider in San Antonio, Texas, licensed in Texas (1210733) and active in the NPI registry since August 2025. She is enrolled in Medicare PECOS and is a graduate of Other (2025).

NPPES Registry Identity

NPI1063391845
Entity TypeIndividualFemale
Primary Taxonomy363LA2100X
Provider Legal NameTHELICIA MATACredential: APRN-CNP
Location Address4502 MEDICAL DRSan Antonio, TX 78229-4402
Mailing Address4502 Medical DrSan Antonio, TX 78229-4402 · (210) 743-0670 · Fax (210) 567-4659
Phone(210) 743-0670
Fax(210) 567-4659
Sole ProprietorNo
Medical School CMSOtherGraduated 2025
Enumeration DateAugust 27, 2025
Last NPPES UpdateNovember 4, 2025
NPPES CertifiedNovember 4, 2025
✔ NPI 1063391845 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyNurse Practitioner · Acute CarePhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LA2100X
License✔ Licensed in TX · 1210733
Also ListedNurse PractitionerTaxonomy 363L00000X · License 1210733 (TX)
Also ListedNurse Practitioner · GerontologyTaxonomy 363LG0600X · License 1210733 (TX)
4502 MEDICAL DR, San Antonio, TX 78229
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Texas, Molina Healthcare.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Thelicia Mata Aprn-cnp is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID2062909682
PECOS Enrollment IDI20251016000993
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 78229 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$84.92 typical visit price
range $54.84 – $166.88
Typical copayment $21.23 (range $13.71 – $41.72)
Most-billed visit code 99203
Established Patient
$97.05 typical visit price
range $17.52 – $136.11
Typical copayment $24.26 (range $4.38 – $34.02)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

EDUARDO N. POLLONO MD
Internal Medicine (Cardiovascular Disease)
4502 MEDICAL DR
SAN ANTONIO, TX 78229
Bexar County (210) 358-4000
DR. MAHDIEH IRAN NEJAD PARIZI M.D.
Student in an Organized Health Care Education/Training Program
4502 MEDICAL DR
SAN ANTONIO, TX 78229
Bexar County (210) 358-2015
RICHARD LEE BALLENTINE D.M.D.
Student in an Organized Health Care Education/Training Program
4502 MEDICAL DR
SAN ANTONIO, TX 78229
Bexar County (210) 358-2015
MR. STEVAN REYES PTA
Physical Therapy Assistant
4502 MEDICAL DR
SAN ANTONIO, TX 78229
Bexar County (210) 358-4253
MRS. CLAIRE LELEUX BEADLE CRNA
Nurse Anesthetist, Certified Registered
4502 MEDICAL DR
SAN ANTONIO, TX 78229
Bexar County (210) 358-4000
NNENNA AWAGU CRNA
Nurse Anesthetist, Certified Registered
4502 MEDICAL DR
SAN ANTONIO, TX 78229
Bexar County (210) 567-4500
DR. CYNTHIA N NGUYEN PHARMD
Pharmacist
4502 MEDICAL DR
SAN ANTONIO, TX 78229
Bexar County (210) 743-4034
DR. JONATHAN EDWARD SLOVIK MD
Hospitalist
4502 MEDICAL DR
SAN ANTONIO, TX 78229
Bexar County (210) 358-4000

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Thelicia Mata's NPI number?

The NPI number for Thelicia Mata is 1063391845. It was assigned to this individual provider in the NPPES registry on August 27, 2025.

Where is Thelicia Mata located?

Thelicia Mata practices at 4502 Medical Dr, San Antonio, TX 78229. The listed phone number is (210) 743-0670.

What is Thelicia Mata's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Acute Care, with taxonomy code 363LA2100X.

Is Thelicia Mata enrolled in Medicare?

Yes. Thelicia Mata is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Thelicia Mata accept?

Health plans from Blue Cross and Blue Shield of Texas and Molina Healthcare list Thelicia Mata as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Thelicia Mata was last updated on November 4, 2025. NPI Profile syncs with the weekly NPPES data releases published by CMS.