Individual provider Active NPI

Matthew R Seely, DO

  • Anesthesiology Physician
  • Farmington, UT
National Provider Identifier
1639198336
Registry record updated Jul 10, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
DO25047 Issued in OR
Practice address
513W Rigby Road
Farmington, UT 84025
Phone
(801) 447-5400
NPI assigned
Jul 19, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X DO25047 OR Primary

Addresses

Primary practice location

513W Rigby Road
Farmington, UT 84025

Mailing address

513W Rigby Road
Farmington, UT 84025
Phone (801) 447-5400

Other identifiers 3

IdentifierTypeStateIssuer
22484MedicaidOR
A055OtherORTRICARE
P00150913OtherORRAILROAD MEDICARE

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120309000269 UT Practitioner - Anesthesiology 4789667882 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Philadelphia College of Osteopathic Medicine, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pediatric Anesthesiologists IncGroup PAC ID 4385618578, 14 clinicians

Practice addresses (Care Compare)

100 N Mario Capecchi Dr
Salt Lake City, UT 84113-1103
Phone (801) 662-4980

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Pediatric Anesthesiologists Inc Anesthesiology CurrentSince Mar 12, 2012 Accepting new patients
Pediatric Anesthesia Associates, PC Anesthesiology PastSince Jul 1, 1997 Accepting new patients
Northwest Anesthesia Physicians PC Anesthesiology Past Accepting new patients

Locations

100 N Mario Capecchi Dr
Slc, UT 84113
Phone (801) 587-7109

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1153267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1215648000000",
    "number": "1639198336",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "513W RIGBY ROAD",
            "city": "FARMINGTON",
            "state": "UT",
            "postal_code": "84025",
            "telephone_number": "801-447-5400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "513W RIGBY ROAD",
            "city": "FARMINGTON",
            "state": "UT",
            "postal_code": "84025",
            "telephone_number": "801-447-5400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEELY",
        "first_name": "MATTHEW",
        "middle_name": "R",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-19",
        "last_updated": "2008-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "OR",
            "license": "DO25047",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "22484",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "A055",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00150913",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Farmington, UT

Sources for this page

Verify at the official NPI Registry.