Kevin L Jansen, M.D.

Primary specialty

Nephrology PhysicianTaxonomy code 207RN0300X

License

6555293-1205 Issued in UT

Practice address

3702 S State St Ste 107
South Salt Lake, UT 84115-5096

Phone

(801) 288-2634

Fax

(801) 288-1186

NPI assigned

Oct 31, 2005

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in UT

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

NephrologyAlso: Internal Medicine

Education

University of Iowa, RJ & L Carver College of Medicine, 1999

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Nephrology Associates of Utah LLCGroup PAC ID 2769468065, 31 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• 462546 FMC-Riverton LLC Dialysis facility, Riverton, UT, CCN 462546
• Intermountain Medical Center Hospital, Murray, UT, CCN 460010
• Holy Cross Hospital-Jordan Valley Hospital, West Jordan, UT, CCN 460051
• St Mark'S Hospital Hospital, Salt Lake City, UT, CCN 460047
• LDS Hospital Hospital, Salt Lake City, UT, CCN 460006
• Intermountain Health Alta View Hospital Hospital, Sandy, UT, CCN 460044

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• UT PPO
• UT PPO D-SNP

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/14360/brand/23/csg/1/fhir/r4
• Direct secure messaging: kjansen31421@direct.acumenmd.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Nephrology Associates of Utah LLC

  • Nephrology Physician
  • Salt Lake City, UT
  • NPI 1750473948
  Medicare reassignment Care Compare group NPD
• Fresenius Medical Care Riverton, LLC

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Riverton, UT
  • NPI 1558746727
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Fresenius Medical Care Riverton, LLC

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Riverton, UT
  • NPI 1558746727

  Dialysis facility

  Care Compare affiliation Name & address match
• Catholic Health Initiatives Colorado

  • General Acute Care Hospital
  • West Jordan, UT
  • NPI 1801591391
  Care Compare affiliation
• Ihc Health Services Inc

  • General Acute Care Hospital
  • Sandy, UT
  • NPI 1962412486
  Care Compare affiliation
• Ihc Health Services, Inc.

  • General Acute Care Hospital
  • Murray, UT
  • NPI 1043220650
  Care Compare affiliation
• Ihc Health Services, Inc.

  • General Acute Care Hospital
  • Salt Lake City, UT
  • NPI 1528078581
  Care Compare affiliation
• Northern Utah Healthcare Corporation

  • General Acute Care Hospital
  • Salt Lake City, UT
  • NPI 1164469243
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1130716800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714608000000",
    "number": "1013908995",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3702 S STATE ST STE 107",
            "city": "SOUTH SALT LAKE",
            "state": "UT",
            "postal_code": "841155096",
            "telephone_number": "801-288-2634",
            "fax_number": "801-288-1186"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3702 S STATE ST STE 107",
            "city": "SOUTH SALT LAKE",
            "state": "UT",
            "postal_code": "841155096",
            "telephone_number": "801-288-2634",
            "fax_number": "801-288-1186"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JANSEN",
        "first_name": "KEVIN",
        "middle_name": "L",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-31",
        "last_updated": "2024-05-02",
        "certification_date": "2024-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "UT",
            "license": "6555293-1205",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4828000340001",
            "state": "UT"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kjansen31421@direct.acumenmd.com",
            "affiliation": "N",
            "address_1": "3702 S State St Ste 107",
            "city": "South Salt Lake",
            "state": "UT",
            "country_code": "US",
            "postal_code": "841155096",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Ruth Merry Indahyung, MD
• Amanda Orme Inkley, RN
• Kristy Ann Jack, CCC
• Dina Marie Jackman
• Taylor Jackson
• Sarah Jensen
• Ty Jensen, ASUDC
• Laurie Jess
• Brianne Michelle Jewell, COTA/L
• Amy Michelle Jewett, MED, CCC-SLP

• Nephrology Physician in South Salt Lake, UT
• Providers in South Salt Lake, UT by specialty
• Nephrology Physician in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.