Dr Jared W Henricksen, MD in Slc, UT

Dr Jared W Henricksen, MD is a medicare enrolled "Pediatrics - Pediatric Critical Care Medicine" physician in Slc, Utah. His current practice location is 100 Mario Capecchi Dr, Slc, Utah. You can reach out to his office (for appointments etc.) via phone at (801) 662-1000.

Dr Jared W Henricksen is licensed to practice in Utah (license number 347933-1205) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1396762480.

Contact Information

	Dr Jared W Henricksen, MD
	100 Mario Capecchi Dr, Slc, UT 84113-1103
	(801) 662-1000
	Not Available

Map and Direction

Physician's Profile

Full Name	Dr Jared W Henricksen
Gender	Male
Speciality	Pediatrics - Pediatric Critical Care Medicine
Location	100 Mario Capecchi Dr, Slc, Utah
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1396762480
Provider Enumeration Date: 07/16/2006
Last Update Date: 04/25/2022

Medicare PECOS Information:

PECOS PAC ID: 4587669981
Enrollment ID: I20080725000300

Medical Identifiers

Medical identifiers for Dr Jared W Henricksen such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1396762480	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
2080P0203X	Pediatrics - Pediatric Critical Care Medicine	347933-1205 (Utah)	Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Dr Jared W Henricksen allows following entities to bill medicare on his behalf.

Entity Name	Ihc Health Services Inc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1942325154 PECOS PAC ID: 1850209420 Enrollment ID: O20080610000303

Entity Name	University Of Utah Pediatric Acuity Care
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1619325131 PECOS PAC ID: 6406148345 Enrollment ID: O20160713000869

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Jared W Henricksen is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Dr Jared W Henricksen, MD 295 Chipeta Way, Po Box 581289, Slc, UT 84108-1287 Ph: (801) 587-7563	Dr Jared W Henricksen, MD 100 Mario Capecchi Dr, Slc, UT 84113-1103 Ph: (801) 662-1000

Reviews and Comments

Pediatrics Doctors in Slc, UT

Molly A O'gorman, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 100 N Medical Dr, Slc, UT 84113 Phone: 801-588-2000
Dr. Venugopal Amula, Pediatrics Medicare: Medicare Enrolled Practice Location: 100 N Mario Capecchi Dr, Slc, UT 84113 Phone: 806-622-2550
Dr. Louis Borgenicht, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 850 E 300 S Ste 5, Slc, UT 84102 Phone: 801-531-8689 Fax: 801-531-1277
James Thomas, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 295 S Chipeta Way, Slc, UT 84108 Phone: 801-581-4178 Fax: 801-587-7417
Spencer Barfuss, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 81 N Mario Capecchi Dr, Slc, UT 84113 Phone: 801-213-7609

Dr Jared W Henricksen, MD - Medicare Pediatrics in Slc, UT