Active NPI
Jacob Brandenburg, M.D.
- Anesthesiology Physician
- Salt Lake City, UT
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiology Physician
- License
- 10970498-1205
- Practice address
- School of Medicine 30 North 1900 East Room 3C444
Salt Lake City, UT 84132 - Phone
- (801) 581-6393
- NPI assigned
- Apr 10, 2017
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | 10970498-1205 | UT | Primary |
Addresses
Primary practice location
School of Medicine 30 North 1900 East Room 3C444
Salt Lake City, UT 84132
Mailing address
School of Medicine 30 North 1900 East Room 3C444
Salt Lake City, UT 84132-0001
Phone (801) 581-6393
Other practice location 1
3181 SW Sam Jackson Park Rd
Portland, OR 97239-3011
Phone (503) 494-8211
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | jbrandenburg62294@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: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Anesthesiology
- Education
- University of Utah School of Medicine, 2017
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1950 Circle of Hope Dr
Salt Lake City, UT 84112-5500
Phone (801) 581-8793
Hospital & facility affiliations
Merit-based Incentive Payment System (MIPS)
- Final score
- 89.77 of 100
- 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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10970498-1205 | UT | MD | Anesthesiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| University of Utah Acuity Care Services | Current | Accepting new patients | |
| University of Utah Acuity Care Services | Current | Accepting new patients | |
| University of Utah Adult Services | Current | Accepting new patients | |
| University of Utah Adult Services | Current | Accepting new patients | |
| University of Utah Acuity Care Services | Current | Accepting new patients |
Locations
250 E 200 S
Ste 1350
Salt Lake City, UT 84111
Phone 80158763362003
30 N 1900 E
Rm 3C444
Slc, UT 84132
Phone (801) 581-3622
1950 Circle of Hope Dr
Slc, UT 84112
Phone (801) 585-0100
50 N Medical Dr
Slc, UT 84132
Phone (801) 581-2292
Interoperability endpoints
- jbrandenburg62294@direct.med.utah.edu
Organizations & group practices 5
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.
-
- General Practice Physician
- Salt Lake City, UT
- NPI 1114321981
-
dba Anesthesiology Dept SICU
- Critical Care Medicine (Anesthesiology) Physician
- Salt Lake City, UT
- NPI 1407250541
-
dba Neurostimulation Adult Services
- Neuromuscular Medicine (Psychiatry & Neurology) Physician
- Salt Lake City, UT
- NPI 1366804254
-
dba MICU-Department of University of Utah
- Critical Care Medicine (Internal Medicine) Physician
- Salt Lake City, UT
- NPI 1851795918
-
dba University of Utah Hospital Radiology Department
- Diagnostic Radiology Physician
- Salt Lake City, UT
- NPI 1598169419
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": "1491782400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1635379200000",
"number": "1366975914",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "SCHOOL OF MEDICINE 30 NORTH 1900 EAST ROOM 3C444",
"city": "SALT LAKE CITY",
"state": "UT",
"postal_code": "841320001",
"telephone_number": "801-581-6393"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "SCHOOL OF MEDICINE 30 NORTH 1900 EAST ROOM 3C444",
"city": "SALT LAKE CITY",
"state": "UT",
"postal_code": "84132",
"telephone_number": "801-581-6393"
}
],
"practiceLocations": [
{
"address_1": "3181 SW Sam Jackson Park Rd",
"address_purpose": "LOCATION",
"city": "Portland",
"state": "OR",
"postal_code": "972393011",
"country_code": "US",
"telephone_number": "503-494-8211",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "BRANDENBURG",
"first_name": "JACOB",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-04-10",
"last_updated": "2021-10-28",
"certification_date": "2021-10-28",
"status": "A"
},
"taxonomies": [
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "UT",
"license": "10970498-1205",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "jbrandenburg62294@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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 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.