Tate Alan Jensen, PAC

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

346683-1206 Issued in UT

Practice address

8211 W 3500 S
Magna, UT 84044-1851

Phone

(801) 250-9638

Fax

(801) 250-3204

NPI assigned

Jul 18, 2006

Last updated

Jul 8, 2007By the provider in NPPES

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

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

Other, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Community Health Centers IncGroup PAC ID 5991698169, 39 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/ACFCAA
• Direct secure messaging: tate.jensen@chcsl.eclinicaldirectplus.com

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.

• Community Health Centers, Inc.

  • Federally Qualified Health Center (FQHC)
  • West Valley City, UT
  • NPI 1952505117

  Family Medicine

  Medicare reassignment Care Compare group NPD
• Community Health Centers, Inc.

  dba 72nd Street Medical Clinic

  • Federally Qualified Health Center (FQHC)
  • Midvale, UT
  • NPI 1073611364

  Family Medicine

  NPD
• Community Health Centers, Inc.

  dba Oquirrh View Medical & Dental Clinic

  • Federally Qualified Health Center (FQHC)
  • Taylorsville, UT
  • NPI 1801992953

  Family Medicine

  NPD (past)
• Exodus Healthcare Network PLLC

  dba Exodus Healthcare

  • Clinic/Center
  • West Valley, UT
  • NPI 1679731319
  NPD (past)

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

{
    "created_epoch": "1153180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1285652867",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8211 W 3500 S",
            "city": "MAGNA",
            "state": "UT",
            "postal_code": "840441851",
            "telephone_number": "801-250-9638",
            "fax_number": "801-250-3204"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8211 W 3500 S",
            "city": "MAGNA",
            "state": "UT",
            "postal_code": "840441851",
            "telephone_number": "801-250-9638",
            "fax_number": "801-250-3204"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JENSEN",
        "first_name": "TATE",
        "middle_name": "ALAN",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-18",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "UT",
            "license": "346683-1206",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Haylee Hudgens, LSAC
• Justin Ingraham
• J&K Care Management LLC (Beehive Homes of Magna)
• Colene James, RN
• Ashley Jensen
• Tanesha Johns
• Bradley L Johnson, DMD
• Cheryl Johnson
• David Lynn Johnson, D.D.S
• Lynn S Johnson, D.D.S.

• Physician Assistant in Magna, UT
• Providers in Magna, UT by specialty
• Physician Assistant in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.