NPIMap

Individual provider Active NPI

Matthew Louis Moench, MD

  • Psychiatry Physician
  • Salt Lake City, UT
National Provider Identifier
1376641456
Registry record updated Jan 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
61668788905 Issued in UT
Practice address
525 E 100 S Ste 5000
Salt Lake City, UT 84102-1992
Phone
(801) 585-1212
Fax
(801) 585-9096
NPI assigned
Sep 20, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 61668788905 UT Primary

Addresses

Primary practice location

525 E 100 S Ste 5000
Salt Lake City, UT 84102-1992

Mailing address

525 E 100 S Ste 5000
Salt Lake City, UT 84102-1992
Phone (801) 585-1212

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mmoench4144@direct.med.utah.edu Direct University of Utah

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070104000089 UT Practitioner - Psychiatry 5193725745 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
University of Virginia School of Medicine, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

501 S Chipeta Way
Salt Lake City, UT 84108-1222
Phone (801) 585-1575

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
89.22 of 100Reported as group
Quality
83.74
Promoting interoperability
100
Improvement activities
40
Cost
66.87

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
61668788905UTMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Utah Acuity Care Services CurrentSince Jun 1, 2016 Accepting new patients
University of Utah Behavioral Health Services CurrentSince Oct 9, 2016 Accepting new patients
University of Utah Behavioral Health Services Psychiatry Current Accepting new patients
University of Utah Acuity Care Services CurrentSince Jun 1, 2016 Accepting new patients
University of Utah Acuity Care Services Current Accepting new patients
University of Utah Behavioral Health Services Psychiatry CurrentSince Oct 9, 2016 Accepting new patients
University of Utah PastSince Jan 28, 2024 Accepting new patients

Locations

525 E 100 S
Ste 500
Salt Lake City, UT 84102
Phone (801) 519-7190

501 S Chipeta Way
Slc, UT 84108
Phone (801) 581-7951

50 N Medical Dr
Slc, UT 84132
Phone (801) 581-2292

650 S Komas Dr
Ste 208
Slc, UT 84108
Phone (801) 585-1212

Interoperability endpoints

  • Direct secure messaging: mmoench4144@direct.med.utah.edu

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.

Hospital & facility affiliations 4

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": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705968000000",
    "number": "1376641456",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "525 E 100 S STE 5000",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841021992",
            "telephone_number": "801-585-1212",
            "fax_number": "801-585-9096"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "525 E 100 S STE 5000",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841021992",
            "telephone_number": "801-585-1212",
            "fax_number": "801-585-9096"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOENCH",
        "first_name": "MATTHEW",
        "middle_name": "LOUIS",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-20",
        "last_updated": "2024-01-23",
        "certification_date": "2023-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "UT",
            "license": "61668788905",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mmoench4144@direct.med.utah.edu",
            "affiliation": "Y",
            "affiliationName": "University of Utah",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/CCD/TXT",
            "address_1": "50 N Medical Dr",
            "city": "Salt Lake City",
            "state": "UT",
            "country_code": "US",
            "postal_code": "841320001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Salt Lake City, UT

Sources for this page

Verify at the official NPI Registry.