Individual provider Active NPI

Mason C Heywood, MD

  • Family Medicine Physician
  • Tooele, UT
National Provider Identifier
1902391857
Registry record updated Dec 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
14071413-1205 Issued in UT
Practice address
1929 N Aaron Dr Ste L
Tooele, UT 84074-8112
Phone
(435) 238-4318
Fax
(435) 237-0107
NPI assigned
Jun 23, 2018
Last updated
Dec 30, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 30, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X RS2018-0571 NM
Family Medicine Physician 207Q00000X M-15889 ID
Family Medicine Physician 207Q00000X 14071413-1205 UT Primary

Addresses

Primary practice location

1929 N Aaron Dr Ste L
Tooele, UT 84074-8112

Mailing address

3340 E Goldstone Dr
Meridian, ID 83642-1026
Phone (208) 367-5170

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
I20241002003120 UT Practitioner - Family Practice 6608115035 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Tooele Clinic CorpGroup PAC ID 6800700873, 63 clinicians

Practice addresses (Care Compare)

1929 N Aaron Dr
Suite L
Tooele, UT 84074-8112
Phone (435) 843-3859

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Removal of skin lesions1-10
Removal or shaving of skin growth1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
M-15889IDMDFamily Medicine Physician
14071413-1205UTMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Tooele Clinic Corp Family Medicine CurrentSince Sep 23, 2024 Accepting new patients

Locations

1929 N Aaron Dr
Ste L
Tooele, UT 84074
Phone (435) 833-9180

2321 N 400 E
Ste 300
Tooele, UT 84074
Phone (435) 833-9180

Interoperability endpoints

  • Direct secure messaging: mason.heywood.1@1562.direct.athenahealth.com
  • Direct secure messaging: mheywood@yourcarecommunity.org
  • Direct secure messaging: mheywood1563852@direct.trinity-health.org

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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": "1529712000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735516800000",
    "number": "1902391857",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3340 E GOLDSTONE DR",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836421026",
            "telephone_number": "208-367-5170",
            "fax_number": "208-367-5180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1929 N AARON DR STE L",
            "city": "TOOELE",
            "state": "UT",
            "postal_code": "840748112",
            "telephone_number": "435-238-4318",
            "fax_number": "435-237-0107"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEYWOOD",
        "first_name": "MASON",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-06-23",
        "last_updated": "2024-12-30",
        "certification_date": "2024-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NM",
            "license": "RS2018-0571",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "ID",
            "license": "M-15889",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "UT",
            "license": "14071413-1205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tooele, UT

Sources for this page

Verify at the official NPI Registry.