Individual provider Active NPI

Michael Jonathan Jaffe, M.D.

  • Pain Medicine (Physical Medicine & Rehabilitation) Physician
  • Salt Lake City, UT
National Provider Identifier
1730119801
Registry record updated Dec 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081P2900X
License
344455-1205 Issued in UT
Practice address
389 S 900 E
Salt Lake City, UT 84102-2310
Phone
(385) 282-2000
Fax
(385) 282-2001
NPI assigned
Jul 4, 2006
Last updated
Dec 4, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X 344455-1205 UT
Pain Medicine (Physical Medicine & Rehabilitation) Physician 2081P2900X 344455-1205 UT Primary

Addresses

Primary practice location

389 S 900 E
Salt Lake City, UT 84102-2310

Mailing address

PO Box 27128
Salt Lake City, UT 84127-0128
Phone (385) 282-2000

Other names 1

  • Michael J. Jaffe Professional name

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101006001187 UT Practitioner - Physical Medicine and Rehabilitation 1153513395 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Medicine and Rehabilitation
Education
University of Massachusetts Medical School, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Interventional Spine and Pain ManagementGroup PAC ID 6204065162, 13 clinicians

Practice addresses (Care Compare)

5801 S Fashion Blvd
Suite 180
Murray, UT 84107-8135
Phone (801) 262-7246

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
344455-1205UTMDPhysical Medicine & Rehabilitation Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Spine and Pain PLLC CurrentSince Apr 1, 2023 Accepting new patients
Interventional Spine & Pain Management CurrentSince Sep 11, 2023 Accepting new patients
Interventional Spine & Pain Management CurrentSince Sep 11, 2023 Accepting new patients
The Smart Clinic Physical Medicine & Rehabilitation PastSince Jan 29, 2023 Accepting new patients

Locations

96 E Kimballs Ln
Ste 408
Draper, UT 84020
Phone (801) 572-1186

560 W 465 N
Ste 604
Providence, UT 84332
Phone (435) 753-1600

5801 S Fashion Blvd
Ste 180
Salt Lake City, UT 84107
Phone (801) 706-2100

24 S 1100 E
Ste 310
Slc, UT 84102
Phone (801) 328-1260

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/HDBECA

Organizations & group practices 4

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1151971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701648000000",
    "number": "1730119801",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 27128",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841270128",
            "telephone_number": "385-282-2000",
            "fax_number": "385-282-2001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "389 S 900 E",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841022310",
            "telephone_number": "385-282-2000",
            "fax_number": "385-282-2001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAFFE",
        "first_name": "MICHAEL",
        "middle_name": "JONATHAN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-04",
        "last_updated": "2023-12-04",
        "certification_date": "2023-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "UT",
            "license": "344455-1205",
            "primary": false
        },
        {
            "code": "2081P2900X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": "UT",
            "license": "344455-1205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MICHAEL",
            "last_name": "JAFFE",
            "middle_name": "J.",
            "credential": "M.D.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Salt Lake City, UT

Sources for this page

Verify at the official NPI Registry.