Individual provider Active NPI

Jon Medler

  • Physician Assistant
  • Salt Lake City, UT
National Provider Identifier
1306332465
Registry record updated May 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
12926956-1206 Issued in UT
Practice address
389 S 900 E
Salt Lake City, UT 84102-2310
Phone
(385) 282-2400
NPI assigned
Jul 2, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 2, 2023

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
Physician Assistant 363A00000X 12926956-1206 UT Primary

Addresses

Primary practice location

389 S 900 E
Salt Lake City, UT 84102-2310

Mailing address

389 S 900 E
Salt Lake City, UT 84102-2310
Phone (385) 282-2400

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
I20230425001556 UT Practitioner - Physician Assistant 5991040255 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ihc Health Services IncGroup PAC ID 1850209420, 3,948 clinicians

Practice addresses (Care Compare)

181 E Medical Tower Dr
Murray, UT 84107-4872
Phone (801) 314-7750

3723 W 1200
Riverton, UT 84065-7296
Phone (801) 535-7035

3723 W 12600
Riverton, UT 84065-7296

3845 W 4700
Taylorsville, UT 84129-3454
Phone (801) 840-8444

389 S 900
Salt Lake City, UT 84102-2310
Phone (385) 282-2400

390 N Main St
Bountiful, UT 84010-6046
Phone (801) 776-4444

5373 W Lake Park Blvd
West Valley City, UT 84120-8208
Phone (801) 902-8080

6272 S Highland Dr
Murray, UT 84121-2126
Phone (801) 871-6300

700 S Hwy 99
Suite 3
Fillmore, UT 84631-5137
Phone (801) 357-4600

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Ihc Health Services, Inc. CurrentSince Apr 12, 2023 Accepting new patients
Ihc Health Services Inc CurrentSince Apr 12, 2023 Accepting new patients

Locations

700 S Highway 99
Ste 3
Fillmore, UT 84631
Phone (435) 743-5555

389 S 900 E
Slc, UT 84102
Phone (385) 282-2000

Interoperability endpoints

  • Direct secure messaging: jonathan.medler.1@14863.direct.athenahealth.com

Organizations & group practices 3

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": "1530489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682985600000",
    "number": "1306332465",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "389 S 900 E",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841022310",
            "telephone_number": "385-282-2400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "389 S 900 E",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841022310",
            "telephone_number": "385-282-2400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEDLER",
        "first_name": "JON",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-07-02",
        "last_updated": "2023-05-02",
        "certification_date": "2023-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "UT",
            "license": "12926956-1206",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salt Lake City, UT

Sources for this page

Verify at the official NPI Registry.