NPIMap

Individual provider Active NPI

Jason T Montgomery, PA

  • Medical Physician Assistant
  • American Fork, UT
National Provider Identifier
1215119953
Registry record updated Nov 4, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
6743553-1206 Issued in UT
Practice address
476 N 900 W
Suite C
American Fork, UT 84003-5199
Phone
(801) 492-1611
Fax
(801) 492-1480
NPI assigned
Dec 5, 2007
Last updated
Nov 4, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 6743553-1206 UT Primary

Addresses

Primary practice location

476 N 900 W
Suite C
American Fork, UT 84003-5199

Mailing address

PO Box 8476
Belfast, ME 04915-8476
Phone (801) 542-8222

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jmontgomery30389@direct.med.utah.edu Direct University of Utah

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081028000354 UT Practitioner - Physician Assistant 9436217908 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

175 N Medical Dr
University of Utah Department of NE
Salt Lake City, UT 84132-1103
Phone (801) 585-7575

50 N Medical Dr
Salt Lake City, UT 84132-0001

590 S Wakara Way
Salt Lake City, UT 84108-1200
Phone (801) 587-7100

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
University of Utah Adult Services CurrentSince Sep 2, 2020 Accepting new patients
University of Utah Surgical Services CurrentSince Aug 14, 2015 Accepting new patients
University of Utah Specialty Services CurrentSince May 1, 2025 Accepting new patients
After Hours Medical LLC, Dba Medallus Medical CurrentSince Jul 11, 2008 Accepting new patients
University of Utah Adult Services CurrentSince Sep 2, 2020 Accepting new patients
Orthopaedic Spine Surgeons Past Accepting new patients
University of Utah Orthopedic Consultants Past Accepting new patients
University of Utah Surgical Services Past Accepting new patients

Locations

476 N 900 W
Ste C
American Fork, UT 84003
Phone (801) 492-1611

175 N Medical Dr
Slc, UT 84112
Phone (801) 581-6908

50 N Medical Dr
Slc, UT 84132
Phone (801) 581-2292

590 S Wakara Way
Slc, UT 84108
Phone (801) 587-7005

Interoperability endpoints

  • Direct secure messaging: jmontgomery30389@direct.med.utah.edu

Organizations & group practices 12

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

Hospital & facility affiliations 4

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

NPI Registry JSON

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

{
    "created_epoch": "1196812800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635984000000",
    "number": "1215119953",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8476",
            "city": "BELFAST",
            "state": "ME",
            "postal_code": "049158476",
            "telephone_number": "801-542-8222",
            "fax_number": "801-542-8227"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "476 N 900 W",
            "address_2": "SUITE C",
            "city": "AMERICAN FORK",
            "state": "UT",
            "postal_code": "840035199",
            "telephone_number": "801-492-1611",
            "fax_number": "801-492-1480"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONTGOMERY",
        "first_name": "JASON",
        "middle_name": "T",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-12-05",
        "last_updated": "2021-11-04",
        "certification_date": "2021-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "UT",
            "license": "6743553-1206",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jmontgomery30389@direct.med.utah.edu",
            "affiliation": "Y",
            "affiliationName": "University of Utah",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/CCD/TXT",
            "address_1": "50 N Medical Dr",
            "city": "Salt Lake City",
            "state": "UT",
            "country_code": "US",
            "postal_code": "841320001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in American Fork, UT

Sources for this page

Verify at the official NPI Registry.