Wendy L Matis, M.D.

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

185450-1205 Issued in UT

Practice address

710 E 200 S
Ste 1B
Salt Lake City, UT 84102-2265

Phone

(801) 521-0100

NPI assigned

Jun 16, 2005

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Specialty

Dermatology

Education

Johns Hopkins University School of Medicine, 1987

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

0 of 100Reported as individual

Quality

0

Improvement activities

0

Cost

0

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://app.meldrx.com/api/fhir/ez_00339

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.

• Matis Dermatology, PC

  • Dermatology Physician
  • Salt Lake City, UT
  • NPI 1790016434
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1118880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1453680000000",
    "number": "1407851595",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9697",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841099697",
            "telephone_number": "801-521-0100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "710 E 200 S",
            "address_2": "STE 1B",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841022265",
            "telephone_number": "801-521-0100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATIS",
        "first_name": "WENDY",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-06-16",
        "last_updated": "2016-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "UT",
            "license": "185450-1205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lesley Mathisen
• Emily Mathurin
• Matia Robotics US Inc.
• Christopher Matich, PA-C
• Matis Dermatology, PC
• Michael E Matlak, MD
• Chanice Marie Matlock
• Tawnya Matlock
• Cindy Brown Matsen, M.D.
• Bill R. Matson, LCSW

• Dermatology Physician in Salt Lake City, UT
• Providers in Salt Lake City, UT by specialty
• Dermatology Physician in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2016; 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.

Verify at the official NPI Registry.