DR. KYLE SHIGERU MATSUMURA (MD) – Interventional Pain Medicine Physician, NPI 1619907490
Interventional Pain Medicine Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for DR. KYLE SHIGERU MATSUMURA (MD)
Highland Drive, Cottonwood Heights, Salt Lake County, Utah, 84121, United States
STE 100
COTTONWOOD HEIGHTS, UT 84121
Phone: (801) 685-7246
Fax: (801) 747-5487
Mailing address matches the actual address.
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 24 Open Payments records for all available years, with a total value of $386.
Total Amount is formed as General ($386) + Research ($0) + Ownership ($0) = $386.
Last reported payment date: 2024-01-10 • Largest payer in this snapshot: Collegium Pharmaceutical, Inc. ($188).
Total Amount
$386
General + Research + Ownership
Payments
24
Total payment records
General Amount
$386
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-01-10
Latest reported date
Top Companies
Largest payers in this snapshot
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: 2003-12-15
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 |
|---|---|---|---|---|
| I20031215000973 | I | Interventional Pain Management | 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.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 1,211 | 263 | $0 |
| 77002 | Fluoroscopic guidance for needle placement | 168 | 88 | $0 |
| 99152 | Use of a drug to induce depression of consciousness by physician performing a procedure (5 years or older), initial 15 minutes | 143 | 72 | $0 |
| 62323 | Injection of substance into lower spine canal using imaging guidance | 142 | 96 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 141 | 76 | $0 |
Insurance plans in this area (ZIP 84121)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| INTERVENTIONAL PAIN MANAGEMENT | UT | 20610 | Aspiration and/or injection of large joint or joint capsule | 147 | 86 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| Pain Management | UT | |
| Interventional Pain Management | UT | |
| - | UT |
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