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JESSICA PETROVICH MD
NPI 1265865125
Family Medicine in Taylorsville, UT

Active since August 14, 2013PECOS EnrolledAccepts Medicare Assignment
4745 S 3200 W, TAYLORSVILLE, UT 84129(801) 964-6214(877) 497-4661 Get Directions Write a Review

NPPES record last updated: June 4, 2020. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Jun 4, 2020, Oct 9, 2018, Mar 29, 2017 (3 updates tracked since 2017).

About Jessica Petrovich Md NPPES

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

JESSICA PETROVICH MD (NPI 1265865125) is an individual family medicine provider in Taylorsville, Utah, licensed in Utah (10964121-1205) and active in the NPI registry since August 2013. She is enrolled in Medicare PECOS, maintains a secondary practice location in Salt Lake City, and is a graduate of Oregon Health Sciences University School Of Medicine (2017).

NPPES Registry Identity

NPI1265865125
Entity TypeIndividualFemale
Primary Taxonomy207Q00000X
Provider Legal NameJESSICA PETROVICHCredential: MD
Location Address4745 S 3200 WTaylorsville, UT 84129-2822
Mailing Address2621 S 3270 WWest Valley City, UT 84119-1119 · (385) 261-2737 · Fax (877) 497-4661
Phone(801) 964-6214
Fax(877) 497-4661
Sole ProprietorNo
Medical School CMSOregon Health Sciences University School Of MedicineGraduated 2017
Enumeration DateAugust 14, 2013
Last NPPES UpdateJune 4, 20203 updates tracked since enumeration
NPPES CertifiedJune 4, 2020
✔ NPI 1265865125 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in UT · 10964121-1205
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
4745 S 3200 W, Taylorsville, UT 84129
Open in Google Maps ↗

Secondary Practice Location 1

Location 1375 S Chipeta Way, Suite ASalt Lake City, UT 84108-1260 · Phone (801) 581-7200

Other Identifiers 1

Medicaid74-2412898UT

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include BridgeSpan Health Company, Molina Healthcare, Regence BlueCross BlueShield of Utah and more.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Jessica Petrovich Md 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.

PECOS PAC ID2062765480
PECOS Enrollment IDI20200611001641
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

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

Community Health Centers, Inc.
2.5 mi
Federally Qualified Health Center (FQHC)
1388 S NAVAJO ST
Salt Lake City, UT 84104
  • Reassigned Medicare billing, Utah enrollment
  • 59 clinicians in this Medicare group
NPI 1255757670 (801) 955-2360

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

Areas of Expertise CMS Part B claims

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Hemoglobin a1c level 83036
Hemoglobin A1c (HbA1c) is a test that measures your average blood sugar level over the past 2-3 months. It's used to monitor how well diabetes is being controlled. High levels may indicate that your diabetes treatment plan needs adjustment.
26 services13 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 84129 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
$84.41 typical visit price
range $54.34 – $166.03
Typical copayment $21.10 (range $13.58 – $41.50)
Most-billed visit code 99203
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.

Other Providers at the Same Location NPPES 20

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

AMBER SHARP HEISE MD
Pediatrics
4745 S 3200 W
TAYLORSVILLE, UT 84129
Salt Lake County (801) 964-6124
ZORICA ANDREA LJUBIC MD
Family Medicine
4745 S 3200 W
TAYLORSVILLE, UT 84129
Salt Lake County (019) 646-2148
ANNIE KATHRYN KORNETZKE DO
Family Medicine
4745 S 3200 W
TAYLORSVILLE, UT 84129
Salt Lake County (801) 964-6214
MS. JAMILIETH CAMPOS ALEJANDRE
Student in an Organized Health Care Education/Training Program
4745 S 3200 W
TAYLORSVILLE, UT 84129
Salt Lake County (801) 964-6214
DR. ANDREW SORENSEN DO
Student in an Organized Health Care Education/Training Program
4745 S 3200 W
TAYLORSVILLE, UT 84129
Salt Lake County (801) 328-4045
DR. LILLIAN ELIZABETH HAYES MD
Family Medicine
4745 S 3200 W
TAYLORSVILLE, UT 84129
Salt Lake County (801) 964-6214
PAIGE HOLBROOK
Dentist (Dental Public Health)
4745 S 3200 W
TAYLORSVILLE, UT 84129
Salt Lake County (801) 964-6214
MARIA DALIA GARZA
Counselor (Mental Health)
4745 S 3200 W
SALT LAKE CITY, UT 84129
Salt Lake County (801) 964-6214

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 Jessica Petrovich's NPI number?

The NPI number for Jessica Petrovich is 1265865125. It was assigned to this individual provider in the NPPES registry on August 14, 2013.

Where is Jessica Petrovich located?

Jessica Petrovich practices at 4745 S 3200 W, Taylorsville, UT 84129. The listed phone number is (801) 964-6214.

What is Jessica Petrovich's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Jessica Petrovich enrolled in Medicare?

Yes. Jessica Petrovich 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.

Which organization bills Medicare for Jessica Petrovich's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Jessica Petrovich reassigns Medicare benefits to Community Health Centers, Inc. (Salt Lake City, UT). 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 Jessica Petrovich's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Jessica Petrovich accept?

Health plans from BridgeSpan Health Company, Molina Healthcare, Regence BlueCross BlueShield of Utah, Select Health and University of Utah Health Plans list Jessica Petrovich 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 Jessica Petrovich was last updated on June 4, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.