Dr Kyle Shigeru Matsumura, MD is a medicare enrolled "Pain Medicine - Interventional Pain Medicine" physician in Cottonwood Heights, Utah. He went to University Of Utah School Of Medicine and graduated in 1993 and has 31 years of diverse experience with area of expertise as Interventional Pain Management. He is a member of the group practice Spine Care Center, Llc and his current practice location is
6750 S Highland Drive, Ste 100, Cottonwood Heights, Utah. You can reach out to his office (for appointments etc.) via phone at
(801) 685-7246.
Dr Kyle Shigeru Matsumura is licensed to practice in Utah (license number 951306801205) and he also participates in the medicare program. He
accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1619907490.
Physician's Profile
| Full Name | Dr Kyle Shigeru Matsumura |
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| Gender | Male |
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| Speciality | Interventional Pain Management |
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| Experience | 31 Years |
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| Location | 6750 S Highland Drive, Cottonwood Heights, Utah |
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| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Dr Kyle Shigeru Matsumura attended and graduated from University Of Utah School Of Medicine in 1993
NPI Data:
- NPI Number: 1619907490
- Provider Enumeration Date: 07/04/2006
- Last Update Date: 03/07/2023
Medicare PECOS Information:
- PECOS PAC ID: 3476450776
- Enrollment ID: I20031215000973
Medical Identifiers
Medical identifiers for Dr Kyle Shigeru Matsumura such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1619907490 | NPI | - | NPPES |
| D5367 | Medicaid | UT | |
| G79891 | Other | UT | CAL MEDICAL LICENSE # |
| 951306801205 | Other | UT | UTAH MEDICAL LICENSE # |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 208VP0014X | Pain Medicine - Interventional Pain Medicine | 951306801205 (Utah) | Primary |
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
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| Spine Care Center, Llc | 4789682352 | 3 |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Dr Kyle Shigeru Matsumura allows following entities to bill medicare on his behalf.
| Entity Name | Spine Care Center, Llc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1992736557
PECOS PAC ID: 4789682352
Enrollment ID: O20061114000306 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Kyle Shigeru Matsumura is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
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Dr Kyle Shigeru Matsumura, MD
6750 S Highland Drive, Ste 100,
Cottonwood Heights, UT 84121
Ph: (801) 685-7246 | Dr Kyle Shigeru Matsumura, MD
6750 S Highland Drive, Ste 100,
Cottonwood Heights, UT 84121
Ph: (801) 685-7246 |
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