Active NPI
Jesse A Jorgensen, PAC
- Physician Assistant
- Layton, UT
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 6124415-1206
- Practice address
- 1580 W Antelope Dr
Suite 100
Layton, UT 84041-1160 - Phone
- (801) 927-1632
- Fax
- (801) 927-1591
- NPI assigned
- Nov 3, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA907 | NV | |
| Physician Assistant | 363A00000X | PA17883 | CA | |
| Physician Assistant | 363A00000X | 6124415-1206 | UT | Primary |
Addresses
Primary practice location
1580 W Antelope Dr
Suite 100
Layton, UT 84041-1160
Mailing address
1566 E 1700 S
SLC, UT 84105
Phone (801) 773-8644
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100505904 | Medicaid | NV | |
| CC7683 | Other | NV | BCBS |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | jjorgensen5588@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: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- University of Utah School of Medicine, 2009
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1525 W 2100
Salt Lake City, UT 84119-1407
Phone (801) 213-9900
Hospital & facility affiliations
Merit-based Incentive Payment System (MIPS)
- Final score
- 89.01 of 100
- Quality
- 94.06
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 69.32
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA17883 | CA | MD | Physician Assistant |
| PA907 | NV | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| University of Utah Community Physicians Group | Current | Accepting new patients | |
| University of Utah Community Physicians Group | Current | Accepting new patients | |
| University of Utah Adult Services | Current | Accepting new patients | |
| University of Utah Adult Services | Current | Accepting new patients | |
| Bronson Lakeview Hospital | Past | Accepting new patients | |
| University Health Care Quick Clinic | Physician Assistant | Past | Accepting new patients |
| Wake Forest University Health Sciences | Past | Accepting new patients | |
| University Primary Care Sports Med | Past | Accepting new patients | |
| University of Utah Community Physicians Group | Past | Accepting new patients |
Locations
26 S Main St
Centerville, UT 84014
Phone (801) 693-7900
165 N University Ave
Farmington, UT 84025
Phone (801) 213-3200
7495 S State St
Midvale, UT 84047
Phone (801) 213-9400
1743 Redstone Center Dr
Ste 115
Park City, UT 84098
Phone (435) 658-9200
1525 W 2100 S
Salt Lake City, UT 84119
Phone (801) 213-8841
127 S 500 E
Ste 200
Salt Lake City, UT 84102
127 S 500 E
Salt Lake Cty, UT 84102
555 Foothill Dr
Slc, UT 84112
Phone (801) 581-7589
1280 E Stringham Ave
Slc, UT 84106
Phone (801) 213-9077
50 N Medical Dr
Slc, UT 84132
Phone (801) 581-2292
5126 W Daybreak Pkwy
Ste 600
South Jordan, UT 84009
220 Millpond
Ste 100
Tooele, UT 84074
Phone (435) 843-3000
Interoperability endpoints
- jjorgensen5588@direct.med.utah.edu
Organizations & group practices 10
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.
-
dba Intensive Outpatient Clinic (Medical)
- Family Medicine Physician
- Salt Lake City, UT
- NPI 1467241554
-
- General Practice Physician
- Salt Lake City, UT
- NPI 1114321981
-
dba University of Utah - Division of Surgical Oncology
- Surgical Oncology Physician
- Salt Lake City, UT
- NPI 1255194833
-
dba University of Utah Hospital Radiology Department
- Diagnostic Radiology Physician
- Salt Lake City, UT
- NPI 1598169419
-
- General Practice Physician
- Salt Lake City, UT
- NPI 1124422126
-
- Physician Assistant
- Holladay, UT
- NPI 1376645671
-
dba UUHC - Redstone Center
- Family Medicine Physician
- Park City, UT
- NPI 1053715763
-
- Sports Medicine (Family Medicine) Physician
- Salt Lake City, UT
- NPI 1699796706
-
dba Bronson Medical Group
- Internal Medicine Physician
- Paw Paw, MI
- NPI 1235131137
-
- Multi-Specialty Clinic/Center
- Winston Salem, NC
- NPI 1003803032
Hospital & facility affiliations 3
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Huntsman Mental Health Institute
- General Acute Care Hospital
- Salt Lake City, UT
- NPI 1487734976
-
dba University Health Care Hospitals and Clinics
- General Acute Care Hospital
- Salt Lake City, UT
- NPI 1588656870
-
dba University Health Care
- General Acute Care Hospital
- Salt Lake City, UT
- NPI 1699889576
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1130976000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1635465600000",
"number": "1336130889",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1566 E 1700 S",
"city": "SLC",
"state": "UT",
"postal_code": "84105",
"telephone_number": "801-773-8644",
"fax_number": "775-246-4186"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1580 W ANTELOPE DR",
"address_2": "SUITE 100",
"city": "LAYTON",
"state": "UT",
"postal_code": "840411160",
"telephone_number": "801-927-1632",
"fax_number": "801-927-1591"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JORGENSEN",
"first_name": "JESSE",
"middle_name": "A",
"name_prefix": "Mr.",
"credential": "PAC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-11-03",
"last_updated": "2021-10-29",
"certification_date": "2021-10-29",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "NV",
"license": "PA907",
"primary": false
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "CA",
"license": "PA17883",
"primary": false
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "UT",
"license": "6124415-1206",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100505904",
"state": "NV"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "CC7683",
"state": "NV"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "jjorgensen5588@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 Layton, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2021; 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.