Kelly Rene Mattimoe, FNP - Medicare Nurse Practitioner in Odessa, TX

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Kelly Rene Mattimoe, FNP is a medicare enrolled "Nurse Practitioner - Family" in Odessa, Texas. Her current practice location is 612 N Washington Ave Ste 200, Odessa, Texas. You can reach out to her office (for appointments etc.) via phone at (432) 332-9263.

Kelly Rene Mattimoe is licensed to practice in Texas (license number 1085712) 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 1235867623.

Contact Information

Kelly Rene Mattimoe, FNP
612 N Washington Ave Ste 200,
Odessa, TX 79761-4436
(432) 332-9263
(432) 332-9264

Map and Direction




Provider's Profile

Full NameKelly Rene Mattimoe
GenderFemale
SpecialityNurse Practitioner - Family
Location612 N Washington Ave Ste 200, Odessa, Texas
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1235867623
  • Provider Enumeration Date: 08/12/2022
  • Last Update Date: 08/12/2022
  Medicare PECOS Information:
  • PECOS PAC ID: 8820474133
  • Enrollment ID: I20221010001823

Medical Identifiers

Medical identifiers for Kelly Rene Mattimoe such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1235867623NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
363LF0000XNurse Practitioner - Family 1085712 (Texas)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. Kelly Rene Mattimoe allows following entities to bill medicare on her behalf.
Entity NameJames Y Li Mdpa
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1093799025
PECOS PAC ID: 8224063441
Enrollment ID: O20050927000862
Entity NameEndovascular Lab Pllc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1407482003
PECOS PAC ID: 1355770371
Enrollment ID: O20200326001442

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. Kelly Rene Mattimoe 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 AddressPractice Location Address
Kelly Rene Mattimoe, FNP
612 N Washington Ave Ste 200,
Odessa, TX 79761-4436

Ph: (432) 332-9263		Kelly Rene Mattimoe, FNP
612 N Washington Ave Ste 200,
Odessa, TX 79761-4436

Ph: (432) 332-9263

Reviews and Comments


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Abidemi Yemisi Adeniran, FNP
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Phone: 432-640-2401    Fax: 432-640-4778
Morris Al Smith, NP-C
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Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

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