Matis Dermatology, PC

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

185450-1205 Issued in UT

Legal business name

MATIS DERMATOLOGY, PC

Practice address

710 E 200 S
Salt Lake City, UT 84102-2265

Phone

(801) 521-0100

Fax

(801) 521-5227

NPI assigned

Jan 20, 2010

Organization subpart

No

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

Authorized official

Name

Dr. Wendy Matis, M.D.NPI 1407851595

Title

Dermatologist

Phone

(801) 521-0100

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in UT

Enrollment records 1

Locations

Interoperability endpoints

• FHIR API: https://app.meldrx.com/api/fhir/ez_00339

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Wendy L Matis, M.D.

  • Dermatology Physician
  • Salt Lake City, UT
  • NPI 1407851595
  Medicare reassignment NPD Authorized official
• Lindsay Helena Wilson, MD

  • Dermatology Physician
  • Taylorsville, UT
  • NPI 1396068342
  NPD (past)

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

{
    "created_epoch": "1263945600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1263945600000",
    "number": "1790016434",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9697",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841099697",
            "telephone_number": "801-521-0100",
            "fax_number": "801-521-5227"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "710 E 200 S",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841022265",
            "telephone_number": "801-521-0100",
            "fax_number": "801-521-5227"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MATIS DERMATOLOGY, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-01-20",
        "last_updated": "2010-01-20",
        "status": "A",
        "authorized_official_last_name": "MATIS",
        "authorized_official_first_name": "WENDY",
        "authorized_official_title_or_position": "DERMATOLOGIST",
        "authorized_official_telephone_number": "801-521-0100",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": "UT",
            "license": "185450-1205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Steve Mathis
• Lesley Mathisen
• Emily Mathurin
• Matia Robotics US Inc.
• Christopher Matich, PA-C
• Wendy L Matis, M.D.
• Michael E Matlak, MD
• Chanice Marie Matlock
• Tawnya Matlock
• Cindy Brown Matsen, M.D.

• Dermatology Physician in Salt Lake City, UT
• Providers in Salt Lake City, UT by specialty
• Dermatology Physician in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.