MR. JATIN R MATTA (NPI# 1316232135) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1316232135 |
| Entity Type | Individual |
| Full Name | MR. JATIN R MATTA |
| Credential | PA-C, MPAS |
| Practice Address |
1450 Mercantile Ln Suite 217 Largo MD 20774-5376 |
| Mailing Address |
16831 Harbour Town Dr Silver Spring MD 20905-4021 |
| Practice Telephone | 3015837770 |
| Practice Fax Number | 3015839414 |
| Mailing Telephone | 3014769226 |
| Enumeration Date | 2011-06-09 |
| Last Update Date | 2011-06-09 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363A00000X | Physician Assistant | PA30146 | DC | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 363A00000X | Physician Assistant | C0002229 | MD | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
1450 MERCANTILE LN SUITE 217 |
| City | LARGO |
| State | MD |
| Zip Code | 20774-5376 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720070261 | David A Gooray | Internal Medicine | 1450 Mercantile Ln, Suite 217, Largo, MD 20774-5376 | 2005-08-19 |
| 1497287361 | Holistic Health & Wellness Medical Spa | Physical Therapist | 1450 Mercantile Ln, 221, Largo, MD 20774-5376 | 2017-03-30 |
| 1831640465 | Anne Arundel Physician Group LLC | Dietitian, Registered | 1450 Mercantile Ln, Suite 111, Largo, MD 20774-5376 | 2016-10-19 |
| 1427505825 | Holistic Health and Wellness Medical Spa | Nurse Practitioner | 1450 Mercantile Ln, Suite 221, Largo, MD 20774-5376 | 2016-09-02 |
| 1972903201 | Heritage Pediatrics, Inc. | Pediatrics | 1450 Mercantile Ln, Suite #217, Largo, MD 20774-5376 | 2014-08-22 |
| 1316372931 | Anne Arundel Physician Group, LLC | Internal Medicine | 1450 Mercantile Ln, Suite 111, Largo, MD 20774-5376 | 2013-09-13 |
| 1679821458 | Meetu Agrawal | Internal Medicine | 1450 Mercantile Ln, Suite 111, Largo, MD 20774-5376 | 2012-08-27 |
| 1750696779 | Susan E Jenkins, M.d.p.a. | Obstetrics & Gynecology | 1450 Mercantile Ln, Suite 117, Largo, MD 20774-5376 | 2010-08-13 |
| 1922249200 | Lisa V. Thompson, Dds, LLC | Clinic/Center | 1450 Mercantile Ln, Suite 207a, Largo, MD 20774-5376 | 2009-03-16 |
| 1992998975 | East Coast Gastroenterology LLC | Pathology | 1450 Mercantile Ln, Suite 217, Largo, MD 20774-5376 | 2007-08-22 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922637156 | Marie Charlotte Teboutsou Tsodzou | Nurse Practitioner | 9317 Lavall Drive, Upper Marlboro, MD 20774 | 2020-04-08 |
| 1467093443 | Richland Support Services Corp. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 11551 Joyceton Drive, Upper Marlboro, MD 20774 | 2019-10-01 |
| 1770134124 | Alan L Kahn | Counselor | 301 Largo Rd., Largo, MD 20774 | 2019-09-26 |
| 1619522034 | Francisca Ifeoma Alintah | Registered Nurse | 511 Dennis Magruder Dr., Upper Marlboro, MD 20774 | 2019-08-02 |
| 1609337146 | Crystal Osuchukwu | Counselor | 1300 Mccormick Dr, Upper Marlboro, MD 20774 | 2019-03-27 |
| 1861968489 | Collaborative Concepts of Maryland | Counselor | 1400 Mercantile Lane, Suite 208, Largo, MD 20774 | 2018-10-22 |
| 1073097622 | Triple Angels Homecare Services, Inc. | In Home Supportive Care | 1210 Dixie Bowie Way, Upper Marlboro, MD 20774 | 2018-09-19 |
| 1922589654 | Optimum Resource Services, LLC | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 711 Harry S. Truman Dr, Unit #105, Largo, MD 20774 | 2018-08-21 |
| 1811475254 | Kolawole Richard Olatunde | Home Health Aide | 11405 Villa Court, Upper Marlboro, MD 20774 | 2018-07-28 |
| 1548747769 | Tiara Williams | Counselor | 15207 Harriet Clotilda Way, Upper Marlboro, MD 20774 | 2018-07-20 |
| Find all providers in zip 20774 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235736794 | Delaney Herper | Physician Assistant | 11049 116th St, Largo, FL 33778-3731 | 2020-10-07 |
| 1376179267 | Latoya Maritza Navarrete | Physician Assistant | 1945 E Bay Dr Apt B, Largo, FL 33771-2217 | 2020-03-23 |
| 1740821677 | Hannah Robinson | Physician Assistant | 12170 119th St, Largo, FL 33778-2000 | 2019-10-02 |
| 1568935971 | Natalie Restrepo | Physician Assistant | 8250 Bryan Dairy Rd Ste 305, Largo, FL 33777-1360 | 2019-01-08 |
| 1821533126 | Darlene Edmunds | Physician Assistant | 8787 Bryan Dairy Rd Ste 310, Largo, FL 33777-1255 | 2016-12-22 |
| 1154573210 | Sarah D Martin | Physician Assistant | 8250 Bryan Dairy Road, Largo, FL 33777-1353 | 2008-10-21 |
| 1205051125 | Jessica Mcgargle Heinberg | Physician Assistant | 1301 2nd Ave Sw Ste 315, Largo, FL 33770 | 2007-04-16 |
| 1770686040 | Paul Badiali | Physician Assistant | 12309 91st Way North, Largo, FL 33773 | 2006-09-05 |
| 1316040694 | Mark V Ward | Physician Assistant | 16370 Walsingham Road, Largo, FL 33774-3532 | 2006-09-05 |
| 1750399226 | Leslie A Pasto Manetta | Physician Assistant | 13670 Walsingham Road, Largo, FL 33774 | 2006-08-03 |
| Find all providers in LARGO | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.