Active NPI
Matias A Calquin, MD
- Family Medicine Physician
- Vineyard, UT
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 12374118-1205
- Practice address
- 667 E 500 N Ste 210
Vineyard, UT 84059-6004 - Phone
- (801) 714-5030
- NPI assigned
- Mar 28, 2020
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 12374118-1205 | UT | Primary |
Addresses
Primary practice location
667 E 500 N Ste 210
Vineyard, UT 84059-6004
Mailing address
PO Box 27128
Salt Lake City, UT 84127-0128
Phone (801) 714-5030
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | https://esmd.officeally.io.8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service | Other | Bluemark LLC / Office Ally |
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20211208001518 | UT | Practitioner - Family Practice | 3971993841 | Reassigns benefits to 2 organizations |
Care Compare profile
Medicare Care Compare- Specialty
- Family Practice
- Education
- University of Utah School of Medicine, 2020
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Ihc Health Services Inc
Practice addresses (Care Compare)
395 W Bulldog Blvd
Suite 205
Provo, UT 84604-3328
Phone (801) 357-1770
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ihc Health Services Inc | Current | Accepting new patients | |
| Mountainlands Community Health Center, Inc | Family Medicine | Current | Accepting new patients |
| Ihc Health Services, Inc. | Current | Accepting new patients | |
| Mountainlands Community Health Center, Inc. | Family Medicine | Current | Accepting new patients |
| Mountainlands Community Health Center, Inc | Family Medicine | Current | Accepting new patients |
| Ihc Health Services Inc | Current | Accepting new patients | |
| Ihc Health Services Inc | Past | Accepting new patients |
Locations
700 S Highway 99
Ste 3
Fillmore, UT 84631
Phone (435) 743-5555
589 S State St
Provo, UT 84606
Phone (801) 420-2000
475 W 940 N
Provo, UT 84604
Phone (801) 357-7909
395 W Cougar Blvd
Ste 205
Provo, UT 84604
Phone (801) 357-1770
354 W State Road 73
Saratoga Springs, UT 84045
Phone (801) 341-5200
667 E 500 N
Ste 210
Vineyard, UT 84059
Phone (801) 714-5030
Organizations & group practices 7
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.
-
- Federally Qualified Health Center (FQHC)
- Provo, UT
- NPI 1427075134
Family Medicine, UT
-
- Emergency Medicine Physician
- North Ogden, UT
- NPI 1033240460
-
- Psychiatry Physician
- St George, UT
- NPI 1023843844
-
- Federally Qualified Health Center (FQHC)
- Payson, UT
- NPI 1437364882
Family Medicine
-
- Federally Qualified Health Center (FQHC)
- Provo, UT
- NPI 1427437144
Family Medicine
-
- Multi-Specialty Clinic/Center
- Orem, UT
- NPI 1588601124
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1585353600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1781481600000",
"number": "1093343980",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 27128",
"city": "SALT LAKE CITY",
"state": "UT",
"postal_code": "841270128",
"telephone_number": "801-714-5030"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "667 E 500 N STE 210",
"city": "VINEYARD",
"state": "UT",
"postal_code": "840596004",
"telephone_number": "801-714-5030"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CALQUIN",
"first_name": "MATIAS",
"middle_name": "A",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-03-28",
"last_updated": "2026-06-15",
"certification_date": "2026-06-15",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "UT",
"license": "12374118-1205",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "https://esmd.officeally.io.8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
"affiliation": "Y",
"endpointDescription": "2.16.840.1.113883.3.2019.3",
"affiliationName": "Bluemark LLC / Office Ally",
"use": "OTHER",
"useDescription": "Other",
"useOtherDescription": "CMS esMD eMDR",
"address_1": "1300 SE Cardinal Ct Ste 190",
"city": "Vancouver",
"state": "WA",
"country_code": "US",
"postal_code": "986839683",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Vineyard, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.