MR. MATTHEW MEMMOTT NEDDO (PA-C, MPAS) – Physician Assistant, NPI 1215091525
Physician Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
1,971 PHYSICIAN ASSISTANT in UT
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Provider Addresses for MR. MATTHEW MEMMOTT NEDDO (PA-C, MPAS)
PO BOX 307
BOUNTIFUL, UT 840110307
Phone: (801) 294-6907
Fax: (801) 294-6917
Type: Mailing
Fashion Boulevard, Murray, Salt Lake County, Utah, 84047, United States
MURRAY, UT 841077352
Phone: (801) 266-6483
Fax: (801) 266-6916
Type: Location
5080 SPECTRUM DR STE 1200W
ADDISON, TX 750014624
Phone: (972) 364-8000
Type: Mailing
2500 S LAKE PARK BLVD
WEST VALLEY CITY, UT 841208218
Phone: (801) 902-4238
Fax: (801) 266-6916
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2008-04-03
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20080403000275 | I | Physician Assistant | UT | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 84011)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Emergency Medicine | UT | |
| - | OR | |
| Family Practice | UT | |
| H O S P I T A L I S T | UT | |
| O B S T E T R I C S/ G Y N E C O L O G Y | UT | |
| - | UT | |
| - | UT | |
| - | UT | |
| Family Practice | UT | |
| - | UT |
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