Individual provider Active NPI

Michael P Eyre

  • MOHS-Micrographic Surgery Physician
  • Spanish Fork, UT
National Provider Identifier
1063481646
Registry record updated Dec 7, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
MOHS-Micrographic Surgery PhysicianTaxonomy code 207ND0101X
License
537110371204 Issued in UT
Practice address
114 E 800 N
Spanish Fork, UT 84660
Phone
(801) 794-1490
Fax
(801) 794-1495
NPI assigned
Mar 16, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 7, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X 5371038-1204 UT
MOHS-Micrographic Surgery Physician 207ND0101X 537110371204 UT Primary

Addresses

Primary practice location

114 E 800 N
Spanish Fork, UT 84660

Mailing address

114 E 800 N
Spanish Fork, UT 84660-1232
Phone (801) 794-1490

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050712000867 UT Practitioner - Dermatology 9739173279 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
At Still University of Health Sciences, College of Osteo Med, Kirksville, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Aspen Dermatology PLLCGroup PAC ID 1355447863, 5 clinicians

Practice addresses (Care Compare)

114 E 800
Spanish Fork, UT 84660-1209
Phone (801) 794-1490

Merit-based Incentive Payment System (MIPS)

Final score
98.69 of 100Reported as group
Quality
97.37
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision44
Removal of tissue1-10
Removal of skin lesions1412
Removal of skin cancer307
Skin biopsy377

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
5371038-1204UTMDDermatology Physician
537110371204UTMDMOHS-Micrographic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Aspen Dermatology PLLC Dermatology CurrentSince Apr 9, 2007 Accepting new patients
SVC Dermatology PC Dermatology PastSince May 1, 2006 Accepting new patients

Locations

1100 S Medical Dr
Mt Pleasant, UT 84647
Phone (435) 462-2441

48 W 1500 N
Nephi, UT 84648
Phone (435) 623-3000

753 S 1040 W
Payson, UT 84651

123 N 500 E
Payson, UT 84651
Phone (801) 377-0580

114 E 800 N
Spanish Fork, UT 84660
Phone (801) 794-1490

114 E 800 N
#R
Spanish Fork, UT 84660

Networks

  • UT PPO
  • UT PPO D-SNP

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1142467200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638835200000",
    "number": "1063481646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "114 E 800 N",
            "city": "SPANISH FORK",
            "state": "UT",
            "postal_code": "846601232",
            "telephone_number": "801-794-1490",
            "fax_number": "801-794-1495"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "114 E 800 N",
            "city": "SPANISH FORK",
            "state": "UT",
            "postal_code": "84660",
            "telephone_number": "801-794-1490",
            "fax_number": "801-794-1495"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EYRE",
        "first_name": "MICHAEL",
        "middle_name": "P",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-16",
        "last_updated": "2021-12-07",
        "certification_date": "2021-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "UT",
            "license": "5371038-1204",
            "primary": false
        },
        {
            "code": "207ND0101X",
            "taxonomy_group": "",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": "UT",
            "license": "537110371204",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Spanish Fork, UT

Sources for this page

Verify at the official NPI Registry.