ELITE ORTHOPEDIC SURGERY AND SPORTS MEDICINE
NPI 1710644463
Orthopaedic Surgery - Sports Medicine in Orem, UT

Q: What is Elite Orthopedic Surgery And Sports Medicine's specialty?

The primary specialty registered for this NPI is Orthopaedic Surgery, specializing in Sports Medicine, with taxonomy code 207XX0005X.

Active since November 17, 2021

980 E 800 N STE 104, OREM, UT 84097(801) 252-4888(801) 252-4887 Get Directions Write a Review

NPPES record last updated: November 17, 2021. Verified against the NPPES registry weekly; last sync: October 18, 2026.

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About Elite Orthopedic Surgery And Sports Medicine NPPES

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

ELITE ORTHOPEDIC SURGERY AND SPORTS MEDICINE (NPI 1710644463) is a healthcare organization registered as a sports medicine in Orem, Utah and active in the NPI registry since November 2021. The organization lists Matthew Poulsen, Owner, as its authorized official.

NPPES Registry Identity

NPI1710644463

Entity TypeOrganization

Primary Taxonomy207XX0005X

Legal Business NameELITE ORTHOPEDIC SURGERY AND SPORTS MEDICINE

Location Address980 E 800 N STE 104Orem, UT 84097-4261

Mailing AddressPo Box 1169Bountiful, UT 84011-1169 · (801) 252-4888 · Fax (801) 252-4887

Phone(801) 252-4888

Fax(801) 252-4887

Organization SubpartNo

Authorized OfficialMatthew PoulsenOwner · (801) 252-4888

Enumeration DateNovember 17, 2021

NPPES CertifiedNovember 17, 2021

✔ NPI 1710644463 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOrthopaedic Surgery · Sports MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207XX0005X

Definition

An orthopaedic surgeon trained in sports medicine provides appropriate care for all structures of the musculoskeletal system directly affected by participation in sporting activity. This specialist is proficient in areas including conditioning, training and fitness, athletic performance and the impact of dietary supplements, pharmaceuticals, and nutrition on performance and health, coordination of care within the team setting utilizing other health care professionals, field evaluation and management, soft tissue biomechanics and injury healing and repair. Knowledge and understanding of the principles and techniques of rehabilitation, athletic equipment and orthotic devices enables the specialist to prevent and manage athletic injuries.

980 E 800 N STE 104, Orem, UT 84097

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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include BridgeSpan Health Company, Molina Healthcare, Regence BlueCross BlueShield of Utah and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, revalidation and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Elite Orthopedic Surgery And Sports Medicine is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Medicare Revalidation Due Date

Revalidation due by December 31, 2026

Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.

StateEnrollment IDDue date

StateUtahEnrollment IDO20220812001614DME · Physician - Orthopedic/Orthopedic SurgeryDue dateDecember 31, 2026

Source: CMS Revalidation Due Date List, October 2026 release.

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Elite Orthopedic Surgery And Sports Medicine, which bills Medicare for the services this clinician delivers.

Clinician (1)

Matthew Poulsen

Orthopedic Surgery

NPI 1881635761

700 W 800 N SUITE 100
Orem, UT 84057

(801) 224-5373

✔ PECOS✔ Accepts Medicare3.1 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Elite Orthopedic Surgery And Sports Medicine's NPI number?

The NPI number for Elite Orthopedic Surgery And Sports Medicine is 1710644463. It was assigned to this organization in the NPPES registry on November 17, 2021.

Where is Elite Orthopedic Surgery And Sports Medicine located?

Elite Orthopedic Surgery And Sports Medicine is located at 980 E 800 N Ste 104, Orem, UT 84097. The listed phone number is (801) 252-4888.

What is Elite Orthopedic Surgery And Sports Medicine's specialty?

The primary specialty registered for this NPI is Orthopaedic Surgery, specializing in Sports Medicine, with taxonomy code 207XX0005X.

Is Elite Orthopedic Surgery And Sports Medicine enrolled in Medicare?

Yes. Elite Orthopedic Surgery And Sports Medicine is registered in the Medicare PECOS enrollment system.

When is Elite Orthopedic Surgery And Sports Medicine's Medicare revalidation due?

According to the CMS Revalidation Due Date List (October 2026 release), the Medicare DME enrollment for this organization (Utah, Physician - Orthopedic/Orthopedic Surgery) is due for revalidation by December 31, 2026. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.

How many clinicians bill Medicare through Elite Orthopedic Surgery And Sports Medicine?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Orthopedic Surgery) reassigns their Medicare billing to Elite Orthopedic Surgery And Sports Medicine. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

What insurance does Elite Orthopedic Surgery And Sports Medicine accept?

Health plans from BridgeSpan Health Company, Molina Healthcare, Regence BlueCross BlueShield of Utah and University of Utah Health Plans list Elite Orthopedic Surgery And Sports Medicine as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Elite Orthopedic Surgery And Sports Medicine was last updated on November 17, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.