NPIMap

Individual provider Active NPI

Jasmin Elizabeth Charles, PA-C

  • Physician Assistant
  • Taylorsville, UT
National Provider Identifier
1912258278
Registry record updated Nov 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
8441458-1206 Issued in UT
Practice address
4745 S 3200 W
Taylorsville, UT 84129-2822
Phone
(801) 964-6214
Fax
(801) 858-4670
NPI assigned
Sep 26, 2012
Last updated
Nov 12, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 12, 2021

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 8441458-1206 UT Primary

Addresses

Primary practice location

4745 S 3200 W
Taylorsville, UT 84129-2822

Mailing address

646 E 3065 S
South Salt Lake, UT 84106-1351
Phone (801) 910-2137

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jcharles41691@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
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161219002436 UT Practitioner - Physician Assistant 4789970054 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
University of Utah School of Medicine, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

50 N Medical Dr
Salt Lake City, UT 84132-0001

50 N Medical Dr
Salt Lake City, UT 84132-0100
Phone (801) 587-6336

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
81.61 of 100Reported as group
Quality
93.24
Promoting interoperability
100
Improvement activities
40
Cost
45.48

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
University of Utah Specialty Services CurrentSince Dec 1, 2016 Accepting new patients
University of Utah Specialty Services CurrentSince Dec 1, 2016 Accepting new patients
University of Utah Adult Services CurrentSince Jan 1, 2019 Accepting new patients
University of Utah Adult Services CurrentSince Jan 1, 2019 Accepting new patients
Bronson Lakeview Hospital Past Accepting new patients
University of Utah Specialty Services Past Accepting new patients

Locations

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

555 Foothill Dr
Slc, UT 84112
Phone (801) 581-7589

Interoperability endpoints

  • Direct secure messaging: jcharles41691@direct.med.utah.edu

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1348617600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636675200000",
    "number": "1912258278",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "646 E 3065 S",
            "city": "SOUTH SALT LAKE",
            "state": "UT",
            "postal_code": "841061351",
            "telephone_number": "801-910-2137"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4745 S 3200 W",
            "city": "TAYLORSVILLE",
            "state": "UT",
            "postal_code": "841292822",
            "telephone_number": "801-964-6214",
            "fax_number": "801-858-4670"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHARLES",
        "first_name": "JASMIN",
        "middle_name": "ELIZABETH",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-09-26",
        "last_updated": "2021-11-12",
        "certification_date": "2021-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "UT",
            "license": "8441458-1206",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jcharles41691@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 Taylorsville, UT

Sources for this page

Verify at the official NPI Registry.