Evan J Matheson, M.D.

Primary specialty

Allergy & Immunology PhysicianTaxonomy code 207K00000X

License

1758051205 Issued in UT

Practice address

745 N 500 W
#200
Provo, UT 84601-1472

Phone

(801) 375-9292

NPI assigned

Nov 8, 2005

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 3

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

Allergy/Immunology

Education

University of Utah School of Medicine, 1985

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Evan J Matheson

  • Clinic/Center
  • Provo, UT
  • NPI 1760677686
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1131408000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1555545600000",
    "number": "1649251646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "745 N 500 W",
            "address_2": "#200",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "846011472",
            "telephone_number": "801-375-9292"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "745 N 500 W",
            "address_2": "#200",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "846011472",
            "telephone_number": "801-375-9292"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATHESON",
        "first_name": "EVAN",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-11-08",
        "last_updated": "2019-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "UT",
            "license": "1758051205",
            "primary": false
        },
        {
            "code": "207K00000X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology",
            "state": "UT",
            "license": "1758051205",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ALTIUS",
            "identifier": "841428839",
            "state": "UT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "0200019",
            "state": "UT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IHC",
            "identifier": "107007559101",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Scott Reid Mason, PT
• Kali Massey, SSW
• Shalai Matagi
• Abigail Belle Mateer, LCSW
• Tavia Mathers, A.P.R.N
• Martin Harston Matheson, LCSW
• Nina Faye Matt
• Edward Matterfis, PHARMD
• Christopher William Matteson, M.S., LAMFT
• Blake Lynn Matthews, DDS

• Allergy & Immunology Physician in Provo, UT
• Providers in Provo, UT by specialty
• Allergy & Immunology Physician in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2019; 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.