Individual provider Active NPI

Jake Harrison Umbarger, PA

  • Physician Assistant
  • SLC, UT
National Provider Identifier
1073257994
Registry record updated Mar 4, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
3338 S 700 E Ste 300a
SLC, UT 84106-1544
Phone
(801) 261-4988
NPI assigned
Apr 26, 2022
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 4, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary
Pain Medicine Physician 208VP0000X 13281983-1206 UT

Addresses

Primary practice location

3338 S 700 E Ste 300a
SLC, UT 84106-1544

Mailing address

3338 S 700 E Ste 300a
SLC, UT 84106-1544
Phone (801) 261-4988

Medicare participation

Medicare enrollment files
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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231005003846 UT Practitioner - Physician Assistant 5597110809 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Omega Interventional Pain PLLCGroup PAC ID 1254512775, 4 clinicians

Practice addresses (Care Compare)

3838 S 700
Suite 300
Salt Lake City, UT 84106-1496
Phone (801) 261-4988

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine, Physician Assistant

State licenses

LicenseStateTypeSpecialty
13281983-1206UTMDPain Medicine Physician

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1650931200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1772582400000",
    "number": "1073257994",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3338 S 700 E STE 300A",
            "city": "SLC",
            "state": "UT",
            "postal_code": "841061544",
            "telephone_number": "801-261-4988"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3338 S 700 E STE 300A",
            "city": "SLC",
            "state": "UT",
            "postal_code": "841061544",
            "telephone_number": "801-261-4988"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "UMBARGER",
        "first_name": "JAKE",
        "middle_name": "HARRISON",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-04-26",
        "last_updated": "2026-03-04",
        "certification_date": "2026-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "208VP0000X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Pain Medicine",
            "state": "UT",
            "license": "13281983-1206",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in SLC, UT

Sources for this page

Verify at the official NPI Registry.