DAVID GUADALUPE MATA JR. ANP
NPI 1790129815
Nurse Practitioner - Adult Health in San Antonio, TX

Q: What is David Mata's NPI number?

The NPI number for David Mata is 1790129815. It was assigned to this individual provider in the NPPES registry on April 19, 2013.

Q: What is David Mata's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Adult Health, with taxonomy code 363LA2200X.

Q: When was this NPI record last updated?

The NPPES record for David Mata was last updated on September 2, 2021. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since April 19, 2013PECOS Enrolled

18707 HARDY OAK BLVD STE 530, SAN ANTONIO, TX 78258(210) 495-8280(210) 481-3116 Get Directions Write a Review

NPPES record last updated: September 2, 2021. Verified against the NPPES registry weekly; last sync: July 26, 2026.

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About David Guadalupe Mata Jr. Anp NPPES

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

DAVID GUADALUPE MATA JR. ANP (NPI 1790129815) is an individual adult health provider in San Antonio, Texas, licensed in Texas (619179) and active in the NPI registry since April 2013. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1790129815

Entity TypeIndividualMale

Primary Taxonomy363LA2200X

Provider Legal NameDAVID GUADALUPE MATA JR.Credential: ANP

Location Address18707 HARDY OAK BLVD STE 530San Antonio, TX 78258-4791

Mailing Address7913 Bandera RdSan Antonio, TX 78250-6511 · (210) 698-9841

Phone(210) 495-8280

Fax(210) 481-3116

Sole ProprietorNo

Enumeration DateApril 19, 2013

Last NPPES UpdateSeptember 2, 2021

NPPES CertifiedSeptember 2, 2021

✔ NPI 1790129815 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · Adult HealthPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LA2200X

License✔ Licensed in TX · 619179

18707 HARDY OAK BLVD STE 530, San Antonio, TX 78258

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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.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

David Guadalupe Mata Jr. Anp is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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 78258 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.

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Other Providers at the Same Location NPPES 5

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

DR. HECTOR JAVIER DIAZ RODRIGUEZ M.D.

Internal Medicine (Nephrology)