Individual provider Active NPI

Matthew D. Sanders

  • Pain Medicine (Anesthesiology) Physician
  • Provo, UT
National Provider Identifier
1639529555
Registry record updated Aug 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X
License
12238992-1205 Issued in UT
Practice address
280 River Park Dr Ste 200
Provo, UT 84604-5793
Phone
(801) 223-4860
NPI assigned
Jun 21, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine (Anesthesiology) Physician 207LP2900X 12238992-1205 UT Primary

Addresses

Primary practice location

280 River Park Dr Ste 200
Provo, UT 84604-5793

Mailing address

280 River Park Dr
Ste 200
Provo, UT 84604-5793
Phone (801) 223-4860

Other practice location 1

145 Kimel Park Dr Ste 330
Winston Salem, NC 27103-6972
Phone (336) 765-6181

Other practice location 2

Wake Forest Baptist Health Medical Center Blvd
Winston Salem, NC 27157-1009
Phone (336) 716-7246

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
I20210827001311 UT Practitioner - Pain ManagementPractitioner - Anesthesiology 1850684150 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pain ManagementAlso: Anesthesiology
Education
Medical College of Wisconsin, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Spinal Interventions, PLLCGroup PAC ID 3476513417, 3 clinicians

Practice addresses (Care Compare)

280 River Park Dr
Suite 200
Provo, UT 84604-5793
Phone (801) 223-4860

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
82.26 of 100Reported as group
Quality
73.08
Improvement activities
40
Cost
76.77

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Spinal Interventions, PLLC Pain Medicine CurrentSince Aug 30, 2021 Accepting new patients

Locations

230 N 1200 E
Ste 201
Lehi, UT 84043
Phone (801) 852-9555

280 River Park Dr
Ste 350
Provo, UT 84604
Phone (801) 223-4860

280 River Park Dr
Ste 200
Provo, UT 84604
Phone (801) 223-4860

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 5

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": "1466467200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629417600000",
    "number": "1639529555",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "280 RIVER PARK DR",
            "address_2": "STE 200",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "846045793",
            "telephone_number": "801-223-4860",
            "fax_number": "801-371-8993"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "280 RIVER PARK DR STE 200",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "846045793",
            "telephone_number": "801-223-4860"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "145 Kimel Park Dr Ste 330",
            "address_purpose": "LOCATION",
            "city": "Winston Salem",
            "state": "NC",
            "postal_code": "271036972",
            "country_code": "US",
            "telephone_number": "336-765-6181",
            "fax_number": "336-765-8492",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "Wake Forest Baptist Health Medical Center Blvd",
            "address_purpose": "LOCATION",
            "city": "Winston Salem",
            "state": "NC",
            "postal_code": "271571009",
            "country_code": "US",
            "telephone_number": "336-716-7246",
            "fax_number": "336-716-8773",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SANDERS",
        "first_name": "MATTHEW",
        "middle_name": "D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-06-21",
        "last_updated": "2021-08-20",
        "certification_date": "2021-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "UT",
            "license": "12238992-1205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Provo, UT

Sources for this page

Verify at the official NPI Registry.