Individual provider Active NPI

Matias A Calquin, MD

  • Family Medicine Physician
  • Vineyard, UT
National Provider Identifier
1093343980
Registry record updated Jun 15, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
12374118-1205 Issued in UT
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

Updated by the provider on Jun 15, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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

TypeEndpointUseAffiliation
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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
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 3,948 clinicians

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

OrganizationSpecialtyStatusNew patients
Ihc Health Services Inc Current Accepting new patients
Mountainlands Community Health Center, Inc Family Medicine Current Accepting new patients
Ihc Health Services, Inc. CurrentSince Oct 1, 2021 Accepting new patients
Mountainlands Community Health Center, Inc. Family Medicine CurrentSince Jul 1, 2023 Accepting new patients
Mountainlands Community Health Center, Inc Family Medicine CurrentSince Jul 1, 2023 Accepting new patients
Ihc Health Services Inc CurrentSince Oct 1, 2021 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.

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

Verify at the official NPI Registry.