Jessica Lynn Gentile

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

9077851-1206 Issued in UT

Practice address

59 S 1100 E
Salt Lake City, UT 84102-1508

Phone

(801) 754-6051

NPI assigned

Jul 16, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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

Specialty

Physician Assistant

Education

University of Utah School of Medicine, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Wasatch Homeless Health Care IncGroup PAC ID 9032271697, 15 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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.

• Wasatch Homeless Health Care, Inc.

  • Federally Qualified Health Center (FQHC)
  • Salt Lake City, UT
  • NPI 1528128899
  Medicare reassignment Care Compare group
• Omega Interventional Pain PLLC

  • Pain Medicine Physician
  • Salt Lake City, UT
  • NPI 1417253907
  Medicare reassignment

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

{
    "created_epoch": "1563235200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646697600000",
    "number": "1205488558",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "59 S 1100 E",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841021508"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "59 S 1100 E",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841021508",
            "telephone_number": "801-754-6051"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2000 Circle Of Hope Dr # 1950",
            "address_purpose": "LOCATION",
            "city": "Salt Lake City",
            "state": "UT",
            "postal_code": "841125550",
            "country_code": "US",
            "telephone_number": "801-587-4348",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GENTILE",
        "first_name": "JESSICA",
        "middle_name": "LYNN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-16",
        "last_updated": "2022-03-08",
        "certification_date": "2022-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "UT",
            "license": "9077851-8906",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "UT",
            "license": "9077851-1206",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Renee Marie Gengelbach
• Amy Marie Genisot, PHARMD
• Vanessa Genova
• Rebekah Gensure, M.D., PH.D.
• Carmella L Gentile
• Kristin Sandra Gentile
• Gentiva Health Services (USA), Inc.
• Crystal Gentry, SLP/MS-CCC
• Jonathan Robert Genzen, MD, PHD
• Alissa Geonzon

• Physician Assistant in Salt Lake City, UT
• Providers in Salt Lake City, UT by specialty
• Physician Assistant in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2022; 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.