NPIMap

Individual provider Active NPI

Paul Russell Jensen, M.D.

  • Diagnostic Radiology Physician
  • Farmington, UT
National Provider Identifier
1528049335
Registry record updated Feb 19, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
1816521205 Issued in UT
Practice address
1433 N 1075 W Ste 104
Farmington, UT 84025
Phone
(801) 298-1300
Fax
(801) 296-6199
NPI assigned
Nov 9, 2005
Last updated
Feb 19, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 19, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 1816521205 UT Primary

Addresses

Primary practice location

1433 N 1075 W Ste 104
Farmington, UT 84025

Mailing address

PO Box 25488
Salt Lake City, UT 84125-0488
Phone (800) 475-3698

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
I20041220000900 UT Practitioner - Diagnostic Radiology 6901864115 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
University of Utah School of Medicine, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Utah Imaging Associates IncGroup PAC ID 1355394537, 45 clinicians

Practice addresses (Care Compare)

630 Medical Dr
Bountiful, UT 84010-4908
Phone (801) 299-2220

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1816521205UTMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Revere Health PC CurrentSince Jun 15, 2021 Accepting new patients
Tanner Memorial Clinic CurrentSince Jan 1, 2016 Accepting new patients
Green River Radiology, P.C. Diagnostic Radiology CurrentSince Dec 15, 2021 Accepting new patients
Tanner Memorial Clinic CurrentSince Jan 1, 2016 Accepting new patients
Revere Health PC CurrentSince Jun 15, 2021 Accepting new patients
Schryver Medical Sales and Marketing LLC Past Accepting new patients
Perspective Counseling Services LLC PastSince Dec 1, 2025 Accepting new patients
Wasatch Vascular Center LLC PastSince Nov 1, 2019 Accepting new patients
Utah Imaging Centers LLC Past Accepting new patients
New Schryver LLC Past Accepting new patients
Scott E Southworth MD PC Past Accepting new patients

Locations

1175 E 50 S
Ste 141
American Fork, UT 84003
Phone (801) 492-5996

380 N 400 W
Kaysville, UT 84037
Phone (801) 547-9500

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

1055 N 500 W
Provo, UT 84604
Phone (801) 429-8000

1055 N 500 W
Ste 112
Provo, UT 84604
Phone (801) 812-4624

12842 S 3600 W
Ste 100
Riverton, UT 84065
Phone (385) 253-4586

6243 S Redwood Rd
Ste 130
Taylorsville, UT 84123
Phone (801) 288-9671

Organizations & group practices 12

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 5

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": "1131494400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1550534400000",
    "number": "1528049335",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 25488",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841250488",
            "telephone_number": "800-475-3698",
            "fax_number": "801-296-6199"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1433 N 1075 W STE 104",
            "city": "FARMINGTON",
            "state": "UT",
            "postal_code": "84025",
            "telephone_number": "801-298-1300",
            "fax_number": "801-296-6199"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JENSEN",
        "first_name": "PAUL",
        "middle_name": "RUSSELL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-09",
        "last_updated": "2019-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "UT",
            "license": "1816521205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Farmington, UT

Sources for this page

Verify at the official NPI Registry.