Individual provider Active NPI

Jason Charl Evans, PA-C

  • Physician Assistant
  • Lehi, UT
National Provider Identifier
1861823635
Registry record updated Dec 4, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
8834881-1206 Issued in UT
Practice address
680 E Main St
Suite 201
Lehi, UT 84043-2241
Phone
(801) 768-8800
Fax
(801) 820-8200
NPI assigned
Dec 4, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 8834881-1206 UT Primary

Addresses

Primary practice location

680 E Main St
Suite 201
Lehi, UT 84043-2241

Mailing address

680 E Main St
Suite 201
Lehi, UT 84043-2241
Phone (801) 768-8800

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
I20140508001957 UT Practitioner - Physician Assistant 2163655598 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Utah Valley Dermatology PCGroup PAC ID 7113181355, 11 clinicians

Practice addresses (Care Compare)

62 E Thrive Dr
Suite 220
Saratoga Springs, UT 84045-5560
Phone (801) 768-8800

680 E Main St
Suite 201
Lehi, UT 84043-2251

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
8834881-1206UTMDPhysician Assistant

Organizations & group practices 1

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": "1386115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1386115200000",
    "number": "1861823635",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "680 E MAIN ST",
            "address_2": "SUITE 201",
            "city": "LEHI",
            "state": "UT",
            "postal_code": "840432241",
            "telephone_number": "801-768-8800",
            "fax_number": "801-820-8200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "680 E MAIN ST",
            "address_2": "SUITE 201",
            "city": "LEHI",
            "state": "UT",
            "postal_code": "840432241",
            "telephone_number": "801-768-8800",
            "fax_number": "801-820-8200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EVANS",
        "first_name": "JASON",
        "middle_name": "CHARL",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-12-04",
        "last_updated": "2013-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "UT",
            "license": "8834881-1206",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lehi, UT

Sources for this page

Verify at the official NPI Registry.