MATTHEW WESTON POMMERVILLE FNP
NPI 1003425356
Nurse Practitioner - Family in Park City, UT

Q: What is Matthew Pommerville's NPI number?

The NPI number for Matthew Pommerville is 1003425356. It was assigned to this individual provider in the NPPES registry on July 23, 2020.

Q: What is Matthew Pommerville's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Active since July 23, 2020PECOS Enrolled

1600 SNOW CREEK DR, PARK CITY, UT 84060(435) 655-0055(435) 655-8979 Get Directions Write a Review

NPPES record last updated: February 18, 2021. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Feb 18, 2021, Aug 10, 2020, Jul 23, 2020 (3 updates tracked since 2020).

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About Matthew Weston Pommerville Fnp NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MATTHEW WESTON POMMERVILLE FNP (NPI 1003425356) is an individual family provider in Park City, Utah, licensed in Utah (8038057-4405) and active in the NPI registry since July 2020. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1003425356

Entity TypeIndividualMale

Primary Taxonomy363LF0000X

Provider Legal NameMATTHEW WESTON POMMERVILLECredential: FNP

Location Address1600 SNOW CREEK DRPark City, UT 84060-7372

Mailing AddressPo Box 198560Atlanta, GA 30384-8560

Phone(435) 655-0055

Fax(435) 655-8979

Sole ProprietorNo

Enumeration DateJuly 23, 2020

Last NPPES UpdateFebruary 18, 20213 updates tracked since enumeration

NPPES CertifiedFebruary 18, 2021

✔ NPI 1003425356 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LF0000X

License✔ Licensed in UT · 8038057-4405

1600 SNOW CREEK DR, Park City, UT 84060

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Matthew Weston Pommerville Fnp is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 84060 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$84.41 typical visit price

range $54.34 – $166.03

Typical copayment $21.10 (range $13.58 – $41.50)

Most-billed visit code 99203

Established Patient

$96.35 typical visit price

range $17.23 – $135.20

Typical copayment $24.08 (range $4.30 – $33.80)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 5

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MOUNTAIN FAMILY HEALTH

Family Medicine