Matthew A. Smith, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

722182 Issued in TX

Practice address

2055 N Main St.
Tooele, UT 84074

Phone

(435) 843-3600

NPI assigned

Oct 3, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 11

Medicare fee-for-service enrollment

Enrolled in UT

Enrollment records 1

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Other, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Desert Peak Anesthesia, LLCGroup PAC ID 6002884996, 8 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Mountain West Medical Center Hospital, Tooele, UT, CCN 460014

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

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.

• Deseret Peak Anesthesia, LLC

  • Certified Registered Nurse Anesthetist
  • Tooele, UT
  • NPI 1518972280
  Medicare reassignment Care Compare group

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Tooele Hospital Corporation

  • General Acute Care Hospital
  • Tooele, UT
  • NPI 1124090659
  Care Compare affiliation

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1235001600000",
    "number": "1114011905",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 268",
            "city": "BOUNTIFUL",
            "state": "UT",
            "postal_code": "840110268",
            "telephone_number": "801-296-2113",
            "fax_number": "801-296-1715"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2055 N MAIN ST.",
            "city": "TOOELE",
            "state": "UT",
            "postal_code": "84074",
            "telephone_number": "435-843-3600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "MATTHEW",
        "middle_name": "A.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-03",
        "last_updated": "2009-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TX",
            "license": "722182",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HMO BLUE",
            "identifier": "86048U",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIRSTCARE COMMERCIAL",
            "identifier": "147826101",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "67417",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS",
            "identifier": "86049U",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "147826100",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200074480A",
            "state": "OK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "202004760",
            "state": "NM"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PRESBYTERIAN COMMERCIAL",
            "identifier": "202004760",
            "state": "NM"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1114011905",
            "state": "UT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "180263901",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "42324777",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Christine Lee Smith, R.N.
• Christopher David Smith, CRNA
• Darin Thomas Smith, P.A.-C.
• David Alan Smith, LPC
• Hans Dalan Smith, DMD
• Robb Smith
• Theodore C Smith, CRNA
• Smiths Food & Drug Centers Inc
• Gary D Snook, MD, PC
• Thomas Cole Snyder, D.C.

• Certified Registered Nurse Anesthetist in Tooele, UT
• Providers in Tooele, UT by specialty
• Certified Registered Nurse Anesthetist in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.

Verify at the official NPI Registry.