DR. MARIANO DE LA MATA (M.D.) – Emergency Medicine Physician, NPI 1396841623
Emergency Medicine Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
12,368 INTERNAL MEDICINE in FL
Provider Addresses for DR. MARIANO DE LA MATA (M.D.)
4405 S US Highway 27
Clermont, FL 347115384
Phone: (352) 720-7999
Type: Location
1200 J D Anderson Dr
Morgantown, WV 265053494
Phone: (304) 598-1200
Type: Location
140 Middletown Loop
Fairmont, WV 265548701
Phone: (304) 598-1914
Type: Location
150 Memorial Dr
Kingwood, WV 265371141
Phone: (304) 329-1400
Type: Location
600 E Dixie Ave
Leesburg, FL 347485925
Phone: (352) 323-5200
Type: Location
3800 Meggison Rd
The Villages, FL 321633028
Phone: (352) 643-7555
Type: Location
1451 El Camino Real
The Villages, FL 321590041
Phone: (352) 643-7555
Type: Location
17021 US Highway 441
Mount Dora, FL 327576734
Phone: (352) 720-7999
Type: Location
PO BOX 100186
GAINESVILLE, FL 326100186
Phone: (352) 265-5911
Fax: (352) 265-5606
Type: Mailing
Corporate Boulevard, Lafayette, Lafayette Parish, Louisiana, 70502, United States
LAFAYETTE, LA 705083870
Phone: (800) 893-9698
Type: Mailing
The Addison at Windermere, Summerport Village Parkway, Lake Butler, Orange County, Florida, 23786, United States
#341
WINDERMERE, FL 347867366
Phone: (865) 406-9069
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 1 Open Payments records for all available years, with a total value of $15.
Total Amount is formed as General ($15) + Research ($0) + Ownership ($0) = $15.
Last reported payment date: 2023-04-05 • Largest payer in this snapshot: ABBVIE INC. ($15).
Total Amount
$15
General + Research + Ownership
Payments
1
Total payment records
General Amount
$15
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2023-04-05
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| ABBVIE INC. | $15 |
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2022-10-14
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 5 Medicare enrollment records; no due dates published yet.
Enrollment records
5
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20041012001084 | I | Emergency Medicine | TN | TBD |
| I20081114000456 | I | Internal Medicine | FL | TBD |
| I20150108002324 | I | Emergency Medicine | TX | TBD |
| I20170410000885 | I | Emergency Medicine | WV | TBD |
| I20221014001184 | I | Emergency Medicine | WY | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 99285 | Emergency department visit with high level of medical decision making | 259 | 253 | $0 |
| 93010 | Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only | 208 | 198 | $0 |
| 99284 | Emergency department visit with moderate level of medical decision making | 154 | 152 | $0 |
| 99291 | Critical care, first 30-74 minutes | 20 | 20 | $0 |
| 99283 | Emergency department visit with low level of medical decision making | 13 | 13 | $0 |
Insurance plans in this area (ZIP 34711)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Nurse Practitioner | WV | |
| H O S P I T A L I S T | WV | |
| Internal Medicine | WV | |
| Internal Medicine | WV | |
| Internal Medicine | WV | |
| Emergency Medicine, Internal Medicine | WV | |
| Nurse Practitioner | WV | |
| Physician Assistant | WV | |
| Interventional Cardiology, Cardiovascular Disease (Cardiology), Internal Medicine | WV | |
| Emergency Medicine, Family Practice | WV |
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