NPIMap

Individual provider Active NPI

Tyson R. Jergensen, MD

  • Pain Medicine (Anesthesiology) Physician
  • Salt Lake City, UT
National Provider Identifier
1366071227
Registry record updated May 18, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X
License
12404285-1205 Issued in UT
Practice address
50 N Medical Dr
Salt Lake City, UT 84132-0001
Phone
(801) 581-3622
NPI assigned
Apr 3, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 18, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine (Anesthesiology) Physician 207LP2900X 12404285-1205 UT Primary

Addresses

Primary practice location

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

Mailing address

PO Box 337
Layton, UT 84041-0337
Phone (801) 773-4840

Other practice location 1

2121 N 1700 W
Layton, UT 84041-8803
Phone (801) 773-4840

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address tjergensen439971@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
I20240711002652 UT Practitioner - Anesthesiology 6901201979 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
University of Texas Medical School at San Antonio, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Tanner Memorial ClinicGroup PAC ID 4284547985, 251 clinicians
University of Utah Adult ServicesGroup PAC ID 0941525273, 1,758 clinicians

Practice addresses (Care Compare)

2121 N 1700
Layton, UT 84041-8803
Phone (801) 773-4840

50 N Medical Dr
Salt Lake City, UT 84132-0001
Phone (801) 581-2121

50 N Medical Dr
Salt Lake City, UT 84132-0100
Phone (801) 213-2995

Hospital & facility affiliations

  • Holy Cross Hospital-Davis Hospital, Layton, UT, CCN 460041
  • University of Utah Hospital and Clinics Hospital, Salt Lake City, UT, CCN 460009

Merit-based Incentive Payment System (MIPS)

Final score
89.77 of 100Reported as group
Quality
91.47
Promoting interoperability
100
Improvement activities
40
Cost
74.42

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
University of Utah Adult Services CurrentSince Jun 1, 2024 Accepting new patients
Tanner Memorial Clinic CurrentSince May 9, 2025 Accepting new patients
University of Utah Adult Services CurrentSince Jun 1, 2024 Accepting new patients
Tanner Memorial Clinic CurrentSince May 9, 2025 Accepting new patients
Tanner Memorial Clinic Current Accepting new patients
University of Utah Adult Services Current Accepting new patients

Locations

1600 W Antelope Dr
Layton, UT 84041
Phone (801) 807-1000

425 S 100 W
Layton, UT 84041
Phone (801) 682-8708

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

Interoperability endpoints

  • Direct secure messaging: tjergensen439971@direct.med.utah.edu
  • Direct secure messaging: tyson.jergensen.p1@direct.tannerclinic.nextgenshare.com

Organizations & group practices 6

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.

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": "1585872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1779062400000",
    "number": "1366071227",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 337",
            "city": "LAYTON",
            "state": "UT",
            "postal_code": "840410337",
            "telephone_number": "801-773-4840"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 N MEDICAL DR",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841320001",
            "telephone_number": "801-581-3622"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2121 N 1700 W",
            "address_purpose": "LOCATION",
            "city": "Layton",
            "state": "UT",
            "postal_code": "840418803",
            "country_code": "US",
            "telephone_number": "801-773-4840",
            "fax_number": "801-525-8151",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JERGENSEN",
        "first_name": "TYSON",
        "middle_name": "R.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-04-03",
        "last_updated": "2026-05-18",
        "certification_date": "2026-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "UT",
            "license": "12404285-1205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tjergensen439971@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 Salt Lake City, UT

Sources for this page

Verify at the official NPI Registry.