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GUADALUPE S MATA CNP
NPI 1700608775
Nurse Practitioner - Family in Santa Rosa, NM

Active since October 30, 2024PECOS EnrolledAccepts Medicare Assignment
117 CAMINO DE VIDA STE 300, SANTA ROSA, NM 88435(575) 472-4311(877) 651-0289 Get Directions Write a Review

NPPES record last updated: October 30, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Guadalupe S Mata Cnp NPPES

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

GUADALUPE S MATA CNP (NPI 1700608775) is an individual family provider in Santa Rosa, New Mexico, licensed in New Mexico (CNP-81461) and active in the NPI registry since October 2024. She is enrolled in Medicare PECOS, maintains 4 additional practice locations, and is a graduate of Other (2024).

NPPES Registry Identity

NPI1700608775
Entity TypeIndividualFemale
Primary Taxonomy363LF0000X
Provider Legal NameGUADALUPE S MATACredential: CNP
Location Address117 CAMINO DE VIDA STE 300Santa Rosa, NM 88435-2267
Mailing Address117 Camino De Vida Ste 300Santa Rosa, NM 88435-2267 · (575) 472-4311 · Fax (877) 641-0289
Phone(575) 472-4311
Fax(877) 651-0289
Sole ProprietorNo
Medical School CMSOtherGraduated 2024
Enumeration DateOctober 30, 2024
NPPES CertifiedOctober 25, 2024
✔ NPI 1700608775 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
License✔ Licensed in NM · CNP-81461
117 CAMINO DE VIDA STE 300, Santa Rosa, NM 88435
Open in Google Maps ↗

Secondary Practice Locations 4

Location 12515 Ridge Runner RdLas Vegas, NM 87701-4972 · Phone (505) 434-0119 · Fax (877) 553-1272
Location 2220 S 3rd StTucumcari, NM 88401-2802 · Phone (575) 461-8631 · Fax (888) 708-0683
Location 3166 Hospital DrRaton, NM 87740-2002 · Phone (575) 445-3626 · Fax (877) 592-0809
Location 41024 S Pacific StreetLas Vegas, NM 87701 · Phone (505) 426-2599 · Fax (877) 553-1272

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

Guadalupe S Mata 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 ID6406382084
PECOS Enrollment IDI20241205002782
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 88435 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
$84.79 typical visit price
range $54.26 – $166.80
Typical copayment $21.19 (range $13.56 – $41.70)
Most-billed visit code 99203
Established Patient
$96.38 typical visit price
range $17.00 – $135.35
Typical copayment $24.09 (range $4.25 – $33.83)
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 13

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

TOMMIE SALINAS CNP
Nurse Practitioner (Family)
117 CAMINO DE VIDA STE 300
SANTA ROSA, NM 88435
Guadalupe County (575) 472-4311
KRISTA NANETTE MERICLE RN
Nurse Practitioner (Family)
117 CAMINO DE VIDA STE 300
SANTA ROSA, NM 88435
Guadalupe County (575) 472-4311
TIMOTHY WILLIAM OVERTON MD
Family Medicine
117 CAMINO DE VIDA STE 300
SANTA ROSA, NM 88435
Guadalupe County (575) 472-4311
SUNRISE CLINICS
Clinic/Center (Federally Qualified Health Center (FQHC))
117 CAMINO DE VIDA STE 300
SANTA ROSA, NM 88435
Guadalupe County (575) 472-4311
SENORA L CAMPOS
Nurse Practitioner (Family)
117 CAMINO DE VIDA STE 300
SANTA ROSA, NM 88435
Guadalupe County (575) 472-4311
JANICE ULIBARRI
Community Health Worker
117 CAMINO DE VIDA STE 300
SANTA ROSA, NM 88435
Guadalupe County (575) 472-4311
DR. MARK LAND GROSSETETE M.D., PH.D.
Psychiatry & Neurology (Neurology)
117 CAMINO DE VIDA STE 300
SANTA ROSA, NM 88435
Guadalupe County (575) 472-4311
BRIAN T MUNIZ PAC
Physician Assistant
117 CAMINO DE VIDA STE 300
SANTA ROSA, NM 88435
Guadalupe County (575) 472-4311

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 Guadalupe Mata's NPI number?

The NPI number for Guadalupe Mata is 1700608775. It was assigned to this individual provider in the NPPES registry on October 30, 2024.

Where is Guadalupe Mata located?

Guadalupe Mata practices at 117 Camino De Vida Ste 300, Santa Rosa, NM 88435. The listed phone number is (575) 472-4311.

What is Guadalupe Mata's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Is Guadalupe Mata enrolled in Medicare?

Yes. Guadalupe 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 Guadalupe Mata was last updated on October 30, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 21 months 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.