1. Home
  2. Directory
  3. Utah
  4. Salt Lake City
  5. Psychiatry Neurology
  6. NPI Profile

JEFFREY PEDERSEN MD
NPI 1316478290
Psychiatry & Neurology - Child & Adolescent Psychiatry in Salt Lake City, UT

Active since March 23, 2017PECOS Enrolled
501 S CHIPETA WAY, SALT LAKE CITY, UT 84108(801) 581-7951 Get Directions Write a Review

NPPES record last updated: July 8, 2022. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Jul 8, 2022, Jun 2, 2020, Mar 23, 2017 (3 updates tracked since 2017).

About Jeffrey Pedersen Md NPPES

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

JEFFREY PEDERSEN MD (NPI 1316478290) is an individual child & adolescent psychiatry provider in Salt Lake City, Utah, licensed in Utah (11762505-1205) and active in the NPI registry since March 2017. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1316478290
Entity TypeIndividualMale
Primary Taxonomy2084P0804X
Provider Legal NameJEFFREY PEDERSENCredential: MD
Location Address501 S CHIPETA WAYSalt Lake City, UT 84108-1222
Mailing Address501 S Chipeta WaySalt Lake City, UT 84108-1222 · (801) 581-7951
Phone(801) 581-7951
Sole ProprietorNo
Enumeration DateMarch 23, 2017
Last NPPES UpdateJuly 8, 20223 updates tracked since enumeration
NPPES CertifiedJuly 8, 2022
✔ NPI 1316478290 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychiatry & Neurology · Child & Adolescent PsychiatryAllopathic & Osteopathic Physicians
Taxonomy Code2084P0804X
License✔ Licensed in UT · 11762505-1205
Definition
Child & Adolescent Psychiatry is a subspecialty of psychiatry with additional skills and training in the diagnosis and treatment of developmental, behavioral, emotional, and mental disorders of childhood and adolescence.
501 S CHIPETA WAY, Salt Lake City, UT 84108
Open in Google Maps ↗

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Jeffrey Pedersen Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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 Reassignments

2

Medicare enrollment records show Jeffrey Pedersen reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

University Of Utah Behavioral Health Services
Same address
Psychiatry
501 S CHIPETA WAY
Salt Lake City, UT 84108
  • Reassigned Medicare billing, Utah enrollment
  • 295 clinicians in this Medicare group
NPI 1093265654 (801) 585-1575
University Of Utah Pediatric Behavioral Health Services
Same address
Child & Adolescent Psychiatry
501 S CHIPETA WAY
Salt Lake City, UT 84108
  • Reassigned Medicare billing, Utah enrollment
  • 111 clinicians in this Medicare group
NPI 1205378320 (801) 587-6336

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 20

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

DR. ERIC THAYNE MONSON MD, PHD
Psychiatry & Neurology (Psychiatry)
501 S CHIPETA WAY
SALT LAKE CITY, UT 84108
Salt Lake County (801) 581-4096
KATRIEL TAN
Student in an Organized Health Care Education/Training Program
501 S CHIPETA WAY
SALT LAKE CITY, UT 84108
Salt Lake County (516) 497-0340
UNIVERSITY OF UTAH PEDIATRIC BEHAVIORAL HEALTH SERVICES
Clinic/Center (Adolescent and Children Mental Health)
501 S CHIPETA WAY
SALT LAKE CITY, UT 84108
Salt Lake County (801) 587-6336
DR. AMY GALLOP WEAGLEY MD
Psychiatry & Neurology (Child & Adolescent Psychiatry)
501 S CHIPETA WAY
SALT LAKE CITY, UT 84108
Salt Lake County (801) 581-2121
ATIYA S NASH
Counselor (Mental Health)
501 S CHIPETA WAY
SALT LAKE CITY, UT 84108
Salt Lake County (801) 587-3000
VALERIE ELIZABETH SHAY MD
Student in an Organized Health Care Education/Training Program
501 S CHIPETA WAY
SALT LAKE CITY, UT 84108
Salt Lake County (801) 581-7951
MAUREEN SIMES
Registered Nurse
501 S CHIPETA WAY
SALT LAKE CITY, UT 84108
Salt Lake County (801) 583-2500
JENNIFER HARMON
Counselor (Mental Health)
501 S CHIPETA WAY
SALT LAKE CITY, UT 84108
Salt Lake County (801) 587-2460

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 Jeffrey Pedersen's NPI number?

The NPI number for Jeffrey Pedersen is 1316478290. It was assigned to this individual provider in the NPPES registry on March 23, 2017.

Where is Jeffrey Pedersen located?

Jeffrey Pedersen practices at 501 S Chipeta Way, Salt Lake City, UT 84108. The listed phone number is (801) 581-7951.

What is Jeffrey Pedersen's specialty?

The primary specialty registered for this NPI is Psychiatry & Neurology, specializing in Child & Adolescent Psychiatry, with taxonomy code 2084P0804X.

Is Jeffrey Pedersen enrolled in Medicare?

Yes. Jeffrey Pedersen is registered in the Medicare PECOS enrollment system.

Which organizations bill Medicare for Jeffrey Pedersen's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Jeffrey Pedersen reassigns Medicare benefits to 2 organizations: University Of Utah Behavioral Health Services (Salt Lake City, UT) and University Of Utah Pediatric Behavioral Health Services (Salt Lake City, UT). Each 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 Jeffrey Pedersen's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Jeffrey Pedersen was last updated on July 8, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.