JACOB IVAN
NPI 1134979347
Family Medicine in Layton, UT
About Jacob Ivan NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
JACOB IVAN (NPI 1134979347) is an individual family medicine provider in Layton, Utah, licensed in Utah (14234161-1205) and active in the NPI registry since March 2024. He is enrolled in Medicare PECOS, maintains a secondary practice location in Ogden, and is a graduate of Texas Tech University Health Science Center School Of Medicine (2024).
NPPES Registry Identity
Specialties & Licenses
Secondary Practice Location 1
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Jacob Ivan is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 84041 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Other Providers at the Same Location NPPES 13
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
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 Jacob Ivan's NPI number?
The NPI number for Jacob Ivan is 1134979347. It was assigned to this individual provider in the NPPES registry on March 22, 2024.
Where is Jacob Ivan located?
Jacob Ivan practices at 201 W Layton Pkwy Ste 1A, Layton, UT 84041. The listed phone number is (801) 543-6875.
What is Jacob Ivan's specialty?
The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.
Is Jacob Ivan enrolled in Medicare?
Yes. Jacob Ivan is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.
When was this NPI record last updated?
The NPPES record for Jacob Ivan was last updated on November 18, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 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.
# Jacob Ivan · NPI 1134979347
Family Medicine physician in Layton, Utah. Individual provider, active in the CMS NPPES registry since March 22, 2024.
## Identity
- **NPI:** 1134979347 (Entity type: Individual)
- **Enumerated:** March 22, 2024
- **Primary specialty:** Family Medicine · taxonomy 207Q00000X
- **State license:** 14234161-1205 (Utah)
- **Sole proprietor:** No
## Practice location
- **Address:** 201 W LAYTON PKWY STE 1A, Layton, UT 84041-3692
- **Phone:** (801) 543-6875
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Medical school:** Texas Tech University Health Science Center School Of Medicine, class of 2024
## Record status
- **NPPES last updated:** November 18, 2025
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Source: [NPI Profile](https://npiprofile.com/npi/1134979347) · Data from the CMS NPPES public registry.