Individual provider Active NPI

Jonathan Robert Genzen, MD, PHD

  • Clinical Pathology Physician
  • Salt Lake City, UT
National Provider Identifier
1922233758
Registry record updated Aug 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Pathology PhysicianTaxonomy code 207ZC0006X
License
8483431-1205 Issued in UT
Practice address
500 Chipeta Way
Mail Code: 115
Salt Lake City, UT 84108
Phone
(801) 583-2787
Fax
(801) 584-5207
NPI assigned
May 22, 2009
Last updated
Aug 30, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 30, 2023

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 253078 NY
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 8483431-1205 UT
Clinical Pathology/Laboratory Medicine Physician 207ZP0105X 8483431-1205 UT
Clinical Pathology Physician 207ZC0006X 8483431-1205 UT Primary

Addresses

Primary practice location

500 Chipeta Way
Mail Code: 115
Salt Lake City, UT 84108

Mailing address

500 Chipeta Way
Mail Code: 115
Salt Lake City, UT 84108
Phone (801) 583-2787

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jgenzen62409@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: 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
I20130411000170 UT Practitioner - Pathology 7719038694 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
University of Chicago, Pritzker School of Medicine, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
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 84132-0100
Phone (801) 585-6387

Hospital & facility affiliations

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
Doctor of Medicine, Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
8483431-1205UTMDClinical Pathology Physician
253078NYMDAnatomic Pathology & Clinical Pathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Utah Adult Services Current Accepting new patients
University of Utah Adult Services CurrentSince Aug 1, 2022 Accepting new patients
Weill Medical College of Cornell Past Accepting new patients

Locations

127 S 500 E
Ste 400B
Salt Lake City, UT 84102
Phone (801) 587-6478

1950 Circle of Hope Dr
Slc, UT 84112
Phone (801) 585-0100

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

Interoperability endpoints

  • Direct secure messaging: jgenzen62409@direct.med.utah.edu

Organizations & group practices 3

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": "1242950400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693353600000",
    "number": "1922233758",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 CHIPETA WAY",
            "address_2": "MAIL CODE: 115",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "84108",
            "telephone_number": "801-583-2787",
            "fax_number": "801-584-5207"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 CHIPETA WAY",
            "address_2": "MAIL CODE: 115",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "84108",
            "telephone_number": "801-583-2787",
            "fax_number": "801-584-5207"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GENZEN",
        "first_name": "JONATHAN",
        "middle_name": "ROBERT",
        "credential": "MD, PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-05-22",
        "last_updated": "2023-08-30",
        "certification_date": "2023-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "NY",
            "license": "253078",
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "UT",
            "license": "8483431-1205",
            "primary": false
        },
        {
            "code": "207ZP0105X",
            "taxonomy_group": "",
            "desc": "Pathology, Clinical Pathology/Laboratory Medicine",
            "state": "UT",
            "license": "8483431-1205",
            "primary": false
        },
        {
            "code": "207ZC0006X",
            "taxonomy_group": "",
            "desc": "Pathology, Clinical Pathology",
            "state": "UT",
            "license": "8483431-1205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jgenzen62409@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.