Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of October 4, 2026.
NPIDirectory

Mario Mata

Individual provider Gerontology Nurse Practitioner · NPI 1053057117

Mario Mata is a Nurse Practitioner in Kirkland, Washington. Qualified in 2018, 8 years ago. Practices with Rejuvenation Medical PLLC, an 11-clinician group and accepts Medicare assignment. Licensed in Washington.

Years since qualifying
8
Licensed in
WA
In the registry since
2022
Specialties on file
2
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Practice location Address checks out

10200 NE 132nd St
Kirkland, WA 98034-2831
Phone: (425) 821-2000
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Adult Health Nurse Practitioner (primary) Taxonomy 363LA2200X · Licence AP60886621 (WA)
Gerontology Nurse Practitioner Taxonomy 363LG0600X · Licence AP60886621 (WA)

Record details

NPI number1053057117
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedMay 10, 2022
Last updated in NPPESMay 10, 2022
Certification dateMay 10, 2022

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2018 (8 years in practice)
Group practice Rejuvenation Medical Pllc — 11 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

Medicare patients and services, 2024

From the CMS Medicare Physician & Other Practitioners file for calendar year 2024. It counts Original Medicare patients only, so a practice that mostly sees Medicare Advantage or privately insured patients looks smaller here than it is.

Medicare patients153
Services billed 804 a service is one billed item, such as a visit, a test or a procedure
Average patient age79

Dollar amounts are not shown. What Medicare pays a practice is gross billings, before staff, premises and tax and including the cost of any drugs it administers, so it is not what a clinician earns.

Practises at

Facilities the CMS Facility Affiliation file lists for this clinician.

Colleagues at Rejuvenation Medical PLLC

Clinicians the CMS Doctors & Clinicians file lists under the same group practice. CMS counts 11 clinicians in the practice; 9 are shown here.

Other providers in Kirkland