Individual provider Active NPI

Matthew Taylor Nelson, D.O.

  • Anesthesiology Physician
  • Saint Louis, MO
National Provider Identifier
1922310929
Registry record updated Jul 7, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
2010017744 Issued in MO
Practice address
6018 Wagon Mount CT
Saint Louis, MO 63129-4043
Phone
(734) 771-1591
NPI assigned
Jul 7, 2010
Last updated
Jul 7, 2010By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 7, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 2010017744 MO Primary

Addresses

Primary practice location

6018 Wagon Mount CT
Saint Louis, MO 63129-4043

Mailing address

6018 Wagon Mount CT
Saint Louis, MO 63129-4043
Phone (734) 771-1591

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
I20140912002131 UT Practitioner - Anesthesiology 2668691270 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mountain View Anesthesia LCGroup PAC ID 5991604829, 32 clinicians

Practice addresses (Care Compare)

1954 E Ft Union Blvd
Suite 105
Salt Lake City, UT 84121-6891
Phone (801) 993-9524

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2010017744MOMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mountain View Anesthesia LC Anesthesiology CurrentSince Aug 5, 2014 Accepting new patients

Locations

1954 E Fort Union Blvd
Ste 105
Salt Lake Cty, UT 84121
Phone (801) 993-9524

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 4

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": "1278460800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1278460800000",
    "number": "1922310929",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6018 WAGON MOUNT CT",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631294043",
            "telephone_number": "734-771-1591"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6018 WAGON MOUNT CT",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631294043",
            "telephone_number": "734-771-1591"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NELSON",
        "first_name": "MATTHEW",
        "middle_name": "TAYLOR",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-07-07",
        "last_updated": "2010-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "MO",
            "license": "2010017744",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.