Individual provider Active NPI

Matthew A Hagemeyer, MD

  • Family Medicine Physician
  • Ogden, UT
National Provider Identifier
1720209380
Registry record updated May 3, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
9405644-1205 Issued in UT
Practice address
698 12TH St
Ogden, UT 84404-6200
Phone
(801) 475-3700
Fax
(801) 475-3701
NPI assigned
May 1, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 3, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 9405644-1205 UT Primary

Addresses

Primary practice location

698 12TH St
Ogden, UT 84404-6200

Mailing address

PO Box 5546
Denver, CO 80217-5546
Phone (801) 475-3700

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
I20150803001197 UT Practitioner - Family Practice 6406925080 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Southern Illinois University School of Medicine, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Ogden Clinic PCGroup PAC ID 9638078033, 104 clinicians

Practice addresses (Care Compare)

5495 S 500
Suite 310
Ogden, UT 84405-7409
Phone (801) 475-3100

6112 S 1550
Ogden, UT 84405-5007
Phone (801) 475-3800

698 12TH St
Ogden, UT 84404-6200
Phone (801) 475-3700

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
9405644-1205UTMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ogden Clinic PC Family Medicine CurrentSince Aug 5, 2015 Accepting new patients
Ogden Clinic Specialty Services LLC Current Accepting new patients
University of Wyoming Family Medicine Past Accepting new patients

Locations

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

1159 12th St
Ogden, UT 84404
Phone (801) 475-3700

5495 S 500 E
Ste 310
Ogden, UT 84405
Phone (801) 475-3100

698 12th St
Ogden, UT 84404
Phone (801) 475-3700

1491 E Ridgeline Dr
South Ogden, UT 84405
Phone (317) 790-7550

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/JJJGBA

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.

Hospital & facility affiliations 3

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": "1177977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620000000000",
    "number": "1720209380",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5546",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802175546",
            "telephone_number": "801-475-3700",
            "fax_number": "801-475-3701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "698 12TH ST",
            "city": "OGDEN",
            "state": "UT",
            "postal_code": "844046200",
            "telephone_number": "801-475-3700",
            "fax_number": "801-475-3701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAGEMEYER",
        "first_name": "MATTHEW",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-01",
        "last_updated": "2021-05-03",
        "certification_date": "2021-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "UT",
            "license": "9405644-1205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ogden, UT

Sources for this page

Verify at the official NPI Registry.