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DR. JENNIFER SHULER DERAMO MD
NPI 1063717551
Pediatrics in Park City, UT

Active since January 14, 2011
1441 UTE BLVD STE 220, PARK CITY, UT 84098(866) 415-6556 Get Directions Write a Review

NPPES record last updated: August 12, 2026. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Aug 12, 2026, Sep 17, 2016, Jun 23, 2016 (3 updates tracked since 2016).

About Dr. Jennifer Shuler Deramo Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. JENNIFER SHULER DERAMO MD (NPI 1063717551) is an individual pediatrics provider in Park City, Utah, licensed in Utah (12377696-1205) and active in the NPI registry since January 2011. She maintains a secondary practice location in Dallas.

NPPES Registry Identity

NPI1063717551
Entity TypeIndividualFemale
Primary Taxonomy208000000X
Provider Legal NameDR. JENNIFER SHULER DERAMOCredential: MD
Location Address1441 UTE BLVD STE 220Park City, UT 84098-7636
Mailing AddressPo Box 27128Salt Lake City, UT 84127-0128
Phone(866) 415-6556
Sole ProprietorNo
Enumeration DateJanuary 14, 2011
Last NPPES UpdateAugust 12, 20263 updates tracked since enumeration
NPPES CertifiedAugust 12, 2026
✔ NPI 1063717551 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians
Taxonomy Code208000000X
License✔ Licensed in UT · 12377696-1205
Definition
A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.
Also ListedPediatrics · Pediatric Emergency MedicineTaxonomy 2080P0204X · License Q5996 (TX)
Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X
1441 UTE BLVD STE 220, Park City, UT 84098
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Other Names 1

Former Name (1)Dr. Jennifer Lynn Shuler Md

Secondary Practice Location 1

Location 15323 Harry Hines BoulevardDallas, TX 75390-7208 · Phone (214) 456-7000 · Fax (214) 456-8132

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Texas, Molina Healthcare, University of Utah Health Plans.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Jennifer Shuler Deramo Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Medicare Billing Reassignment

Medicare enrollment records show Jennifer Deramo reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

University Of Texas Southwestern Medical Center At Dallas
678 mi
Internal Medicine
1625 MEDICAL CENTER DR
El Paso, TX 79902
  • Reassigned Medicare billing, Texas enrollment
  • 5,299 clinicians in this Medicare group
NPI 1235384199 (214) 645-0624

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Other Providers at the Same Location NPPES 5

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

EILEEN GALLAGHER MD
Pediatrics
1441 UTE BLVD STE 220
PARK CITY, UT 84098
Summit County (435) 602-0187
IHC HEALTH SERVICES, INC.
Pediatrics
1441 UTE BLVD STE 220
PARK CITY, UT 84098
Summit County (801) 442-2000
GAIL TEASLEY RN
Registered Nurse
1441 UTE BLVD STE 220
PARK CITY, UT 84098
Summit County (435) 513-0054
DR. HANNAH LEIGHTON BEAL-MALOTT MD
Pediatrics
1441 UTE BLVD STE 220
PARK CITY, UT 84098
Summit County (801) 442-2000
GALLAGHER PEDIATRICS
Pediatrics
1441 UTE BLVD STE 220
PARK CITY, UT 84098
Summit County (435) 602-0187

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jennifer Deramo's NPI number?

The NPI number for Jennifer Deramo is 1063717551. It was assigned to this individual provider in the NPPES registry on January 14, 2011. The provider is also known as Dr. Jennifer Lynn Shuler MD.

Where is Jennifer Deramo located?

Jennifer Deramo practices at 1441 Ute Blvd Ste 220, Park City, UT 84098. The listed phone number is (866) 415-6556.

What is Jennifer Deramo's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

Is Jennifer Deramo enrolled in Medicare?

Yes. Jennifer Deramo is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Jennifer Deramo's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Jennifer Deramo reassigns Medicare benefits to University Of Texas Southwestern Medical Center At Dallas (El Paso, TX). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Jennifer Deramo's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Jennifer Deramo accept?

Health plans from Blue Cross and Blue Shield of Texas, Molina Healthcare and University of Utah Health Plans list Jennifer Deramo as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Jennifer Deramo was last updated on August 12, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.