NPIMap

Individual provider Active NPI

Jean Grose

  • Medical Physician Assistant
  • Salt Lake City, UT
National Provider Identifier
1871003285
Registry record updated Nov 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
10491953-1206 Issued in UT
Practice address
30 N 1900 E RM 4A100
Salt Lake City, UT 84132-0002
Phone
(801) 585-7676
NPI assigned
Oct 11, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 2, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 10491953-1206 UT
Medical Physician Assistant 363AM0700X 10491953-1206 UT Primary

Addresses

Primary practice location

30 N 1900 E RM 4A100
Salt Lake City, UT 84132-0002

Mailing address

3673 S 805 E Apt 1
Salt Lake City, UT 84106-4637

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jgrose65121@direct.med.utah.edu Direct UNIVERSITY OF UTAH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT, WY, NV3 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20180110002702 UT Practitioner - Physician Assistant 5890054217 Reassigns benefits to 1 organization
I20210125001950 WY Practitioner - Physician Assistant 5890054217 Reassigns benefits to 1 organization
I20210225003349 NV Practitioner - Physician Assistant 5890054217 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
University of Utah Adult ServicesGroup PAC ID 0941525273, 1,758 clinicians

Practice addresses (Care Compare)

50 N Medical Dr
Salt Lake City, UT 84132-0001
Phone (801) 581-2121

50 N Medical Dr
Salt Lake City, UT 84132-0100
Phone (801) 213-2995

Hospital & facility affiliations

  • University of Utah Hospital and Clinics Hospital, Salt Lake City, UT, CCN 460009

Merit-based Incentive Payment System (MIPS)

Final score
89.77 of 100Reported as group
Quality
91.47
Promoting interoperability
100
Improvement activities
40
Cost
74.42

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
10491953-1206UTMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
University of Utah Adult Services CurrentSince Jan 1, 2021 Accepting new patients
University of Utah Adult Services CurrentSince Dec 15, 2017 Accepting new patients
University of Utah Adult Services CurrentSince Dec 15, 2017 Accepting new patients
University of Utah Adult Services CurrentSince Oct 21, 2020 Accepting new patients
Bronson Lakeview Hospital Medical Past Accepting new patients

Locations

247 Bluffs Ave
Ste 102
Elko, NV 89801
Phone (775) 369-2799

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

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

1200 College Dr
Rock Springs, WY 82901
Phone (307) 352-8352

Interoperability endpoints

  • Direct secure messaging: jgrose65121@direct.med.utah.edu
  • Direct secure messaging: jgrose@yourcarecommunity.org

Organizations & group practices 8

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": "1507680000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635811200000",
    "number": "1871003285",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3673 S 805 E APT 1",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841064637"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 N 1900 E RM 4A100",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841320002",
            "telephone_number": "801-585-7676"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GROSE",
        "first_name": "JEAN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-10-11",
        "last_updated": "2021-11-02",
        "certification_date": "2021-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "UT",
            "license": "10491953-1206",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "UT",
            "license": "10491953-1206",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jgrose65121@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.