Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Matthew Warner

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1275355034

Matthew Warner is a Physician Assistant in Provo, Utah. Qualified in 2024, 2 years ago. Practices with Revere Health PC, a 410-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Utah.

Years since qualifying
2
Licensed in
UT
In the registry since
2024
Specialties on file
2
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Practice location Address checks out

1055 N 500 W Ste 100
Provo, UT 84604-3305
Phone: (801) 374-1268
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 14194730-1206 (UT)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1275355034
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedOctober 31, 2024
Last updated in NPPESFebruary 10, 2025
Certification dateFebruary 6, 2025
Mailing address1055 N 500 W, Attn Credentialing, Provo, UT 84604-3305

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2024 (2 years in practice)
Group practice Revere Health Pc — 410 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

Other providers in Provo