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DR. JILL M ZABLOCKI PSY.D.
NPI 1164609665
Psychologist - Clinical in Salt Lake City, UT

Active since January 28, 2008Opted out of Medicare · through Jan 10, 2028
574 E 12TH AVE, SALT LAKE CITY, UT 84103(801) 875-1926(646) 843-4713 Get Directions Write a Review

NPPES record last updated: November 4, 2016. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Dr. Jill M Zablocki Psy.d. NPPES

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

DR. JILL M ZABLOCKI PSY.D. (NPI 1164609665) is an individual clinical provider in Salt Lake City, Utah, licensed in Utah (9226522-2501) and active in the NPI registry since January 2008. She has opted out of Medicare through January 10, 2028.

NPPES Registry Identity

NPI1164609665
Entity TypeIndividualFemale
Primary Taxonomy103TC0700X
Provider Legal NameDR. JILL M ZABLOCKICredential: PSY.D.
Location Address574 E 12TH AVESalt Lake City, UT 84103-3224
Mailing Address574 E 12th AveSalt Lake City, UT 84103-3224 · (801) 875-1926 · Fax (646) 843-4713
Phone(801) 875-1926
Fax(646) 843-4713
Sole ProprietorYes
Enumeration DateJanuary 28, 2008
Last NPPES UpdateNovember 4, 2016
✔ NPI 1164609665 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychologist · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code103TC0700X
Licenses✔ Licensed in UT · 9226522-2501✔ Licensed in NY · 017071✔ Licensed in NJ · 5088
Definition
A psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in breadth -- one that is broadly inclusive of severe psychopathology -- and marked by comprehensiveness and integration of knowledge and skill from a broad array of disciplines within and outside of psychology proper. The scope of clinical psychology encompasses all ages, multiple diversities and varied systems.
574 E 12TH AVE, Salt Lake City, UT 84103
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Dr. Jill M Zablocki Psy.d. has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from January 10, 2020 through January 10, 2028.

Opt-Out Effective DateJanuary 10, 2020
Opt-Out In Effect ThroughJanuary 10, 2028Opt-out affidavits renew automatically every two years unless cancelled
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesAn opted-out provider can still order and refer for Medicare patients in the categories marked above, even though their own services are not covered.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 84103 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$166.03 typical visit price
range $54.34 – $166.03
Typical copayment $41.50 (range $13.58 – $41.50)
Most-billed visit code 99205
Established Patient
$96.35 typical visit price
range $17.23 – $135.20
Typical copayment $24.08 (range $4.30 – $33.80)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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 Jill Zablocki's NPI number?

The NPI number for Jill Zablocki is 1164609665. It was assigned to this individual provider in the NPPES registry on January 28, 2008.

Where is Jill Zablocki located?

Jill Zablocki practices at 574 E 12th Ave, Salt Lake City, UT 84103. The listed phone number is (801) 875-1926.

What is Jill Zablocki's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Clinical, with taxonomy code 103TC0700X.

Is Jill Zablocki enrolled in Medicare?

No. Jill Zablocki has opted out of Medicare through January 10, 2028. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out.

When was this NPI record last updated?

The NPPES record for Jill Zablocki was last updated on November 4, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 years 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.