Rodrigo B Mata III, M.D., S.C.
NPI 1588847099ActiveOrganization· Internal Medicine· Kenosha, WI
Internal Medicine in Kenosha, Wisconsin, registered in NPPES in December 2007. The authorized official on file is Rodrigo B. Mata, M.D., M.D. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1588847099 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Dec 7, 2007 |
| Last updated in NPPES | Jun 3, 2020 |
| Certified by provider | Jun 3, 2020 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Internal Medicine Primary | 207R00000X | 33893 | WI |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (WI) |
|---|
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