Individual provider Active NPI

Matthew Roger Olson, DO

  • Orthopaedic Surgery Physician
  • Phoenix, AZ
National Provider Identifier
1730403494
Registry record updated Sep 16, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
006957 Issued in AZ
Practice address
18444 N 25TH Ave
210
Phoenix, AZ 85023-1261
Phone
(866) 974-2673
Fax
(866) 939-2673
NPI assigned
Mar 23, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 5101018746 MI
Orthopaedic Surgery Physician 207X00000X 006957 AZ Primary

Addresses

Primary practice location

18444 N 25TH Ave
210
Phoenix, AZ 85023-1261

Mailing address

18444 N 25TH Ave
310
Phoenix, AZ 85023-1261
Phone (866) 974-2673

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
I20170421001285 UT Practitioner - Orthopedic Surgery 0345489829 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
Des Moines University of Osteopathic Medicine and Health Sciences, 2010
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)

1350 N 500
Logan, UT 84341-2400
Phone (435) 716-1770

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hip replacement33
Knee replacement33
Lower limb (leg) arthroscopy (minimally invasive joint repair)1-10
Upper limb (arm) arthroscopy (minimally invasive joint repair)1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
006957AZMDOrthopaedic Surgery Physician
5101018746MIMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ihc Health Services Inc Current Accepting new patients
Ihc Health Services, Inc. CurrentSince Apr 17, 2017 Accepting new patients
Ihc Health Services Inc CurrentSince Apr 17, 2017 Accepting new patients
Center for Orthopedic Research and Education, LLC Orthopaedic Surgery Past Accepting new patients
Ihc Health Services Inc Past Accepting new patients

Locations

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

1350 N 500 E
North Logan, UT 84341
Phone (435) 716-2800

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 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": "1269302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1473984000000",
    "number": "1730403494",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18444 N 25TH AVE",
            "address_2": "310",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850231261",
            "telephone_number": "866-974-2673",
            "fax_number": "866-939-2673"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18444 N 25TH AVE",
            "address_2": "210",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850231261",
            "telephone_number": "866-974-2673",
            "fax_number": "866-939-2673"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLSON",
        "first_name": "MATTHEW",
        "middle_name": "ROGER",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-03-23",
        "last_updated": "2016-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MI",
            "license": "5101018746",
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "AZ",
            "license": "006957",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.