Individual provider Active NPI

Matthew Ray Pickup, APRN - CRNA

  • Certified Registered Nurse Anesthetist
  • Salt Lake City, UT
National Provider Identifier
1285385229
Registry record updated Jan 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
8659807-8901 Issued in UT
Practice address
1050 E South Temple
Salt Lake City, UT 84102-1507
Phone
(801) 750-2888
NPI assigned
Jan 11, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 11, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 8659807-8901 UT Primary

Addresses

Primary practice location

1050 E South Temple
Salt Lake City, UT 84102-1507

Mailing address

311 E 1700 S
Salt Lake City, UT 84115-1729
Phone (801) 750-2888

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220506000882 UT Practitioner - Certified Registered Nurse Anesthetist (Crna) 6800273137 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
NPH Anesthesia of Utah LLCGroup PAC ID 9537584313, 91 clinicians

Practice addresses (Care Compare)

5475 S 500
Ogden, UT 84405-6905
Phone (469) 998-7443

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
8659807-8901UTMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
NPH Anesthesia of Utah, LLC CurrentSince Jan 28, 2022 Accepting new patients

Locations

2221 Lakeside Blvd
Ste 600
Richardson, TX 75082
Phone (469) 998-7450

1050 E South Temple
Slc, UT 84102
Phone (801) 350-4111

1525 E 6000 S
South Ogden, UT 84405
Phone (801) 337-5800

5475 S 500 E
South Ogden, UT 84405
Phone (801) 479-2111

3580 W 90th S
West Jordan, UT 84088
Phone (801) 263-0810

Organizations & group practices 1

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.

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1641859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641859200000",
    "number": "1285385229",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "311 E 1700 S",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841151729",
            "telephone_number": "801-750-2888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1050 E SOUTH TEMPLE",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841021507",
            "telephone_number": "801-750-2888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PICKUP",
        "first_name": "MATTHEW",
        "middle_name": "RAY",
        "credential": "APRN - CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-01-11",
        "last_updated": "2022-01-11",
        "certification_date": "2022-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "UT",
            "license": "8659807-8901",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salt Lake City, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2022; 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.