K-MATA LLC
NPI 1790655108
Family Medicine in Tucker, GA
About K-mata Llc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
K-MATA LLC (NPI 1790655108) is a healthcare organization registered as a family medicine in Tucker, Georgia and active in the NPI registry since November 2025. The organization lists Byron Oswaldo Mata Gonzalez, President, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Group Practice 1
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
K-mata Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
Medicare enrollment records show 1 clinician reassigns Medicare billing to K-Mata LLC, which bills Medicare for the services this clinician delivers.
Clinician (1)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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 K-Mata LLC's NPI number?
The NPI number for K-Mata LLC is 1790655108. It was assigned to this organization in the NPPES registry on November 10, 2025.
Where is K-Mata LLC located?
K-Mata LLC is located at 4292 Chamblee Tucker Rd, Tucker, GA 30084. The listed phone number is (770) 718-1517.
What is K-Mata LLC's specialty?
The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.
Is K-Mata LLC enrolled in Medicare?
Yes. K-Mata LLC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through K-Mata LLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Internal Medicine) reassigns their Medicare billing to K-Mata LLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
When was this NPI record last updated?
The NPPES record for K-Mata LLC was last updated on November 10, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 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.
# K-Mata Llc · NPI 1790655108
Family Medicine organization in Tucker, Georgia. Organization record, active in the CMS NPPES registry since November 10, 2025.
## Identity
- **NPI:** 1790655108 (Entity type: Organization)
- **Enumerated:** November 10, 2025
- **Primary specialty:** Family Medicine · taxonomy 207Q00000X
- **Organization subpart:** No
- **Authorized official:** Byron Mata Gonzalez, PRESIDENT
## Practice location
- **Address:** 4292 CHAMBLEE TUCKER RD, Tucker, GA 30084-2103
- **Phone:** (770) 718-1517 · **Fax:** (770) 718-1518
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 1 clinician (Internal Medicine) reassigns Medicare billing to this organization (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** November 10, 2025
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Source: [NPI Profile](https://npiprofile.com/npi/1790655108) · Data from the CMS NPPES public registry.