Individual provider Active NPI

Jennifer Mary Pantelakis, NP-C

  • Family Nurse Practitioner
  • Salt Lake City, UT
National Provider Identifier
1467805135
Registry record updated Nov 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
7691455-4405 Issued in UT
Practice address
2511 S 800 E
Salt Lake City, UT 84106-1728
Phone
(801) 486-1963
NPI assigned
Jul 18, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 10, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 7691455-4405 UT Primary

Addresses

Primary practice location

2511 S 800 E
Salt Lake City, UT 84106-1728

Mailing address

2511 S 800 E
Salt Lake City, UT 84106-1728
Phone (801) 486-1963

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address jpantelakis46455@direct.med.utah.edu Direct UNIVERSITY OF UTAH
Direct Messaging Address jpantelakis46455@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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161116002581 UT Practitioner - Nurse Practitioner 3577842459 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
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 100Reported as group
Quality
94.06
Promoting interoperability
100
Improvement activities
40
Cost
69.32

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
University of Utah Adult Services CurrentSince Oct 19, 2016 Accepting new patients
University of Utah Adult Services CurrentSince Oct 19, 2016 Accepting new patients
University of Utah Community Physicians Group CurrentSince Oct 19, 2016 Accepting new patients
University of Utah Adult Services Current Accepting new patients
University of Utah Community Physicians Group CurrentSince Oct 19, 2016 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

145 W University Pkwy
Orem, UT 84058
Phone (801) 226-7555

1743 Redstone Center Dr
Ste 115
Park City, UT 84098
Phone (435) 658-9200

555 Foothill Dr
Ste 301
Salt Lake City, UT 84112
Phone (801) 585-5385

555 Foothill Dr
Ste 600
Salt Lake City, UT 84112

1525 W 2100 S
Salt Lake City, UT 84119
Phone (801) 213-8841

1138 E Wilmington Ave
Slc, UT 84106
Phone (801) 581-2000

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

1280 E Stringham Ave
Slc, UT 84106
Phone (801) 213-9077

5126 W Daybreak Pkwy
Ste 600
South Jordan, UT 84009

220 Millpond
Ste 100
Tooele, UT 84074
Phone (435) 843-3000

3730 W 4700 S
West Valley City, UT 84129
Phone (801) 213-9200

Interoperability endpoints

  • Direct secure messaging: jpantelakis46455@direct.med.utah.edu

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 3

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": "1468800000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636502400000",
    "number": "1467805135",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2511 S 800 E",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841061728",
            "telephone_number": "801-486-1963"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2511 S 800 E",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841061728",
            "telephone_number": "801-486-1963"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PANTELAKIS",
        "first_name": "JENNIFER",
        "middle_name": "MARY",
        "name_prefix": "Mrs.",
        "credential": "NP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-07-18",
        "last_updated": "2021-11-10",
        "certification_date": "2021-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "UT",
            "license": "7691455-4405",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jpantelakis46455@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"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jpantelakis46455@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.