Individual provider Active NPI

Brian Mattsson, PA-C

  • Physician Assistant
  • Layton, UT
National Provider Identifier
1538564653
Registry record updated Feb 12, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
10441201-1206 Issued in UT
Practice address
2121 N 1700 W
Layton, UT 84041-8803
Phone
(801) 773-4840
Fax
(801) 525-8151
NPI assigned
Oct 31, 2014
Last updated
Feb 12, 2020By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 12, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 10441201-1206 UT Primary

Addresses

Primary practice location

2121 N 1700 W
Layton, UT 84041-8803

Mailing address

PO Box 337
Layton, UT 84041-0337
Phone (801) 773-4840

Other identifiers 1

IdentifierTypeStateIssuer
1538564653MedicaidUT

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171012003183 UT Practitioner - Physician Assistant 8022383322 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ihc Health Services IncGroup PAC ID 1850209420, 3,948 clinicians

Practice addresses (Care Compare)

1915 W 5950
Roy, UT 84067-1454
Phone (801) 387-8100

201 W Layton Pkwy
Layton, UT 84041-3692

2400 N Washington Blvd
North Ogden, UT 84414-7233
Phone (435) 792-1770

700 S Hwy 99
Suite 3
Fillmore, UT 84631-5137
Phone (801) 357-4600

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Ihc Health Services, Inc. CurrentSince Jan 21, 2024 Accepting new patients
Ihc Health Services Inc CurrentSince Jan 21, 2024 Accepting new patients
Aleracare of Utah Inc Past Accepting new patients

Locations

700 S Highway 99
Ste 3
Fillmore, UT 84631
Phone (435) 743-5555

2400 N Washington Blvd
Ogden, UT 84414
Phone (801) 387-8300

4650 Harrison Blvd
Ogden, UT 84403
Phone (801) 475-3481

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1414713600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581465600000",
    "number": "1538564653",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 337",
            "city": "LAYTON",
            "state": "UT",
            "postal_code": "840410337",
            "telephone_number": "801-773-4840",
            "fax_number": "801-525-8151"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2121 N 1700 W",
            "city": "LAYTON",
            "state": "UT",
            "postal_code": "840418803",
            "telephone_number": "801-773-4840",
            "fax_number": "801-525-8151"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATTSSON",
        "first_name": "BRIAN",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-10-31",
        "last_updated": "2020-02-12",
        "certification_date": "2020-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "UT",
            "license": "10441201-1206",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1538564653",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Layton, UT

Sources for this page

Verify at the official NPI Registry.