JERICHO DE MATA D.O.
NPI 1275950396
Family Medicine in Upper Marlboro, MD

Active since March 26, 2014PECOS EnrolledAccepts Medicare Assignment
1221 MERCANTILE LN, UPPER MARLBORO, MD 20774(301) 618-5500 Get Directions Write a Review

NPPES record last updated: June 20, 2021. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jun 20, 2021, Mar 17, 2018, Sep 14, 2017 (3 updates tracked since 2017).

About Jericho De Mata D.o. NPPES

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

JERICHO DE MATA D.O. (NPI 1275950396) is an individual family medicine provider in Upper Marlboro, Maryland, licensed in Maryland (H83783) and active in the NPI registry since March 2014. He is enrolled in Medicare PECOS, maintains a secondary practice location in Washington, and is a graduate of Other (2014).

NPPES Registry Identity

NPI1275950396
Entity TypeIndividualMale
Primary Taxonomy207Q00000X
Provider Legal NameJERICHO DE MATACredential: D.O.
Location Address1221 MERCANTILE LNUpper Marlboro, MD 20774-5374
Mailing Address2101 E Jefferson St Ste 6wRockville, MD 20852-4908 · (301) 816-5853
Sole ProprietorNo
Medical School CMSOtherGraduated 2014
Enumeration DateMarch 26, 2014
Last NPPES UpdateJune 20, 20213 updates tracked since enumeration
NPPES CertifiedJune 20, 2021
NPI 1275950396 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
Licenses Licensed in MD · H83783 Licensed in VA · 0102205000 Licensed in DC · MD045539
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
1221 MERCANTILE LN, Upper Marlboro, MD 20774

Secondary Practice Location 1

Location 12139 Georgia Ave NW Ste 3BWashington, DC 20001-3006 · Phone (202) 865-6100

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

Jericho De Mata D.o. 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 ID3971879958
PECOS Enrollment IDI20171018002053
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.

Areas of Expertise CMS Part B claims

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
14 services14 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 20774 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
$100.31 typical visit price
range $65.18 – $194.86
Typical copayment $25.07 (range $16.29 – $48.71)
Most-billed visit code 99203
Established Patient
$113.72 typical visit price
range $21.40 – $158.88
Typical copayment $28.43 (range $5.35 – $39.72)
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.

Psychiatry & Neurology (Psychiatry)
1221 MERCANTILE LN
LARGO, MD 20774
Anesthesiology
1221 MERCANTILE LN
UPPER MARLBORO, MD 20774
Internal Medicine
1221 MERCANTILE LN, KAISER PERMANENTE LARGO MEDICAL CENTER
LARGO, MD 20774
Obstetrics & Gynecology (Maternal & Fetal Medicine)
1221 MERCANTILE LN, DEPT OF OBGYN
LARGO, MD 20774
Anesthesiology
1221 MERCANTILE LN
UPPER MARLBORO, MD 20774
Physician Assistant
1221 MERCANTILE LN, KAISER PERMANENTE LARGO MEDICAL CENTER
LARGO, MD 20774
Urology
1221 MERCANTILE LN, KAISER PERMANENTE DEPARTMENT OF UROLOGY
LARGO, MD 20774
Obstetrics & Gynecology
1221 MERCANTILE LN
UPPER MARLBORO, MD 20774

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 Jericho De Mata's NPI number?

The NPI number for Jericho De Mata is 1275950396. It was assigned to this individual provider in the NPPES registry on March 26, 2014.

Where is Jericho De Mata located?

Jericho De Mata practices at 1221 Mercantile Ln, Upper Marlboro, MD 20774. The listed phone number is (301) 618-5500.

What is Jericho De Mata's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Jericho De Mata enrolled in Medicare?

Yes. Jericho De 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.

When was this NPI record last updated?

The NPPES record for Jericho De Mata was last updated on June 20, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.