Haylie Ashtyn Mata, is a medicare enrolled "Nurse Practitioner - Family" in Boswell, Oklahoma. Her current practice location is
50 E 2040 Rd, Boswell, Oklahoma. You can reach out to her office (for appointments etc.) via phone at
(580) 920-5870.
Haylie Ashtyn Mata is licensed to practice in Oklahoma (license number 220582) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1992525976.
Provider's Profile
Full Name | Haylie Ashtyn Mata |
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Gender | Female |
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Speciality | Nurse Practitioner - Family |
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Location | 50 E 2040 Rd, Boswell, Oklahoma |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1992525976
- Provider Enumeration Date: 10/14/2024
- Last Update Date: 10/14/2024
Medicare PECOS Information:
- PECOS PAC ID: 6901335637
- Enrollment ID: I20250125000135
Medical Identifiers
Medical identifiers for Haylie Ashtyn Mata such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1992525976 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
363LF0000X | Nurse Practitioner - Family | 220582 (Oklahoma) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Haylie Ashtyn Mata allows following entities to bill medicare on her behalf.
Entity Name | Durant Hma Physician Management Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1043361116 PECOS PAC ID: 3375638976 Enrollment ID: O20070927000304 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Haylie Ashtyn Mata is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Haylie Ashtyn Mata, 50 E 2040 Rd, Boswell, OK 74727-9385 Ph: (580) 920-5870 | Haylie Ashtyn Mata, 50 E 2040 Rd, Boswell, OK 74727-9385 Ph: (580) 920-5870 |
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