NPIMap

Individual provider Active NPI

Christopher Matich, PA-C

  • Physician Assistant
  • Salt Lake City, UT
National Provider Identifier
1760859300
Registry record updated Nov 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
5539823-1206 Issued in UT
Practice address
6360 S 3000 E
Ste 100
Salt Lake City, UT 84121-6923
Phone
(801) 365-1032
Fax
(801) 365-1033
NPI assigned
Aug 31, 2015
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 20, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 5539823-1206 UT
Physician Assistant 363A00000X 5539823-1206 UT Primary

Addresses

Primary practice location

6360 S 3000 E
Ste 100
Salt Lake City, UT 84121-6923

Mailing address

6360 S 3000 E
Ste 100
Salt Lake City, UT 84121-6923
Phone (801) 365-1032

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address cmatich412958@direct.med.utah.edu Direct University of Utah

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151023000494 UT Practitioner - Physician Assistant 9133438609 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1525 W 2100
Salt Lake City, UT 84119-1407
Phone (801) 213-9900

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
University of Utah Community Physicians Group CurrentSince Nov 9, 2019 Accepting new patients
University of Utah Community Physicians Group CurrentSince Nov 9, 2019 Accepting new patients
University of Utah Community Physicians Group Past Accepting new patients

Locations

1743 Redstone Center Dr
Ste 115
Park City, UT 84098
Phone (435) 658-9200

1525 W 2100 S
Salt Lake City, UT 84119
Phone (801) 213-8841

50 N Medical Dr
Slc, UT 84132
Phone (801) 581-2292

Interoperability endpoints

  • Direct secure messaging: cmatich412958@direct.med.utah.edu

Organizations & group practices 4

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": "1440979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637366400000",
    "number": "1760859300",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6360 S 3000 E",
            "address_2": "STE 100",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841216923",
            "telephone_number": "801-365-1032",
            "fax_number": "801-365-1033"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6360 S 3000 E",
            "address_2": "STE 100",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841216923",
            "telephone_number": "801-365-1032",
            "fax_number": "801-365-1033"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATICH",
        "first_name": "CHRISTOPHER",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-08-31",
        "last_updated": "2021-11-20",
        "certification_date": "2021-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "UT",
            "license": "5539823-1206",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "UT",
            "license": "5539823-1206",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cmatich412958@direct.med.utah.edu",
            "affiliation": "Y",
            "affiliationName": "University of Utah",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/CCD/TXT",
            "address_1": "50 N Medical Dr",
            "city": "Salt Lake City",
            "state": "UT",
            "country_code": "US",
            "postal_code": "841320001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Salt Lake City, UT

Sources for this page

Verify at the official NPI Registry.