Individual provider Active NPI

Matthew Davis, MD

  • Dermatology Physician
  • Salt Lake City, UT
National Provider Identifier
1780200253
Registry record updated Dec 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
25544 Issued in NH
Practice address
Helix: 30 N Mario Capecchi RM 1S100
Salt Lake City, UT 84112
Phone
(801) 581-2121
NPI assigned
Jun 22, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 10, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X 25544 NH Primary
Dermatology Physician 207N00000X 13869905-1205 UT
MOHS-Micrographic Surgery Physician 207ND0101X 13869905-1205 UT
Internal Medicine Physician 207R00000X 2020015723 MO

Addresses

Primary practice location

Helix: 30 N Mario Capecchi RM 1S100
Salt Lake City, UT 84112

Mailing address

PO Box 810
Hanover, NH 03755-0810
Phone (603) 308-1472

Other practice location 1

1 Medical Center Dr
Lebanon, NH 03756-1000
Phone (603) 650-5000

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address mdavis693874@direct.med.utah.edu Direct University of Utah
Direct Messaging Address Matthew.Davis@mercy.net

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT, NH2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20240726002659 UT Practitioner - Dermatology 3173946951 Reassigns benefits to 1 organization
I20250918003203 NH Practitioner - Dermatology 3173946951 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mary Hitchcock Memorial HospitalGroup PAC ID 4486561164, 1,269 clinicians

Practice addresses (Care Compare)

18 Old Etna Rd
Lebanon, NH 03766-1937
Phone (603) 650-4000

Hospital & facility affiliations

  • Mary Hitchcock Memorial Hospital Hospital, Lebanon, NH, CCN 300003

Merit-based Incentive Payment System (MIPS)

Final score
81.84 of 100Reported as group
Quality
87.03
Promoting interoperability
100
Improvement activities
40
Cost
52.42

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision93
Removal of skin lesions45
Removal of skin cancer366
Removal of nail tissue1-10
Removal or shaving of skin growth1-10
Skin biopsy28

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25544NHMDDermatology Physician
13869905-1205UTMDMOHS-Micrographic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mary Hitchcock Memorial Hospital CurrentSince Sep 1, 2025 Accepting new patients
Dermatology Division University of Utah Medical Center Dermatology CurrentSince Jul 1, 2024 Accepting new patients
Dartmouth-Hitchcock Clinic Internal Medicine CurrentSince Sep 1, 2025 Accepting new patients
Mary Hitchcock Memorial Hospital Internal Medicine Current Accepting new patients
Mary Hitchcock Memorial Hospital Internal Medicine CurrentSince Sep 1, 2025 Accepting new patients
U-U Pediatric Dermatology PastSince May 24, 2020 Accepting new patients

Locations

18 Old Etna Rd
Lebanon, NH 03766
Phone (603) 650-3100

1 Medical Dr
Lebanon, NH 03756
Phone (603) 650-5922

127 S 500 E
Ste 400
Salt Lake City, UT 84102

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

Interoperability endpoints

  • Direct secure messaging: mdavis428004@direct.dartmouth-hitchcock.org
  • Direct secure messaging: matthew.davis@mercy.net

Organizations & group practices 6

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 2

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": "1592784000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765324800000",
    "number": "1780200253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 810",
            "city": "HANOVER",
            "state": "NH",
            "postal_code": "037550810",
            "telephone_number": "603-308-1472"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "HELIX: 30 N MARIO CAPECCHI RM 1S100",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "84112",
            "telephone_number": "801-581-2121"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Medical Center Dr",
            "address_purpose": "LOCATION",
            "city": "Lebanon",
            "state": "NH",
            "postal_code": "037561000",
            "country_code": "US",
            "telephone_number": "603-650-5000",
            "fax_number": "603-640-1228",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "MATTHEW",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-06-22",
        "last_updated": "2025-12-10",
        "certification_date": "2025-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NH",
            "license": "25544",
            "primary": true
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "UT",
            "license": "13869905-1205",
            "primary": false
        },
        {
            "code": "207ND0101X",
            "taxonomy_group": "",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": "UT",
            "license": "13869905-1205",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MO",
            "license": "2020015723",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mdavis693874@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"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Matthew.Davis@mercy.net",
            "affiliation": "N",
            "endpointDescription": "Institutional email address",
            "address_1": "615 S New Ballas Rd",
            "city": "Saint Louis",
            "state": "MO",
            "country_code": "US",
            "postal_code": "631418221",
            "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.