JACKIE ANNE FONUA PA-C
NPI 1336227206
Family Medicine in West Jordan, UT

Q: What is Jackie Fonua's NPI number?

The NPI number for Jackie Fonua is 1336227206. It was assigned to this individual provider in the NPPES registry on November 1, 2006.

Q: What is Jackie Fonua's specialty?

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

Q: When was this NPI record last updated?

The NPPES record for Jackie Fonua was last updated on July 8, 2007. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since November 01, 2006PECOS EnrolledAccepts Medicare Assignment

3354 W 7800 S, WEST JORDAN, UT 84088(801) 282-2677(801) 282-2050 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: July 26, 2026.

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About Jackie Anne Fonua Pa-c NPPES

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

JACKIE ANNE FONUA PA-C (NPI 1336227206) is an individual family medicine provider in West Jordan, Utah, licensed in Utah (175335-1206) and active in the NPI registry since November 2006. She is enrolled in Medicare PECOS, is affiliated with Intermountain Medical Center, and is a graduate of Other (1996).

NPPES Registry Identity

NPI1336227206

Entity TypeIndividualFemale

Primary Taxonomy207Q00000X

Provider Legal NameJACKIE ANNE FONUACredential: PA-C

Location Address3354 W 7800 SWest Jordan, UT 84088-4506

Mailing Address3354 W 7800 SWest Jordan, UT 84088-4506 · (801) 282-2677 · Fax (801) 282-2050

Phone(801) 282-2677

Fax(801) 282-2050

Sole ProprietorNo

Medical School CMSOtherGraduated 1996

Enumeration DateNovember 1, 2006

Last NPPES UpdateJuly 8, 2007

✔ NPI 1336227206 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 · 175335-1206

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.

3354 W 7800 S, West Jordan, UT 84088

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Other Identifiers 2

Medicare UPINP29300UT

Medicare ID-Type Unspecified000012428UT

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include BridgeSpan Health Company, Imperial Health Plan of the Southwest, Inc., Molina Healthcare and more.Insurance ›

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

Jackie Anne Fonua Pa-c 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 ID3779597489

PECOS Enrollment IDI20060202000186

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.

Areas of Expertise CMS Part B claims 10

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.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

93 services58 patients

Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more 99215

This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.

76 services59 patients

Urine microalbumin (protein) level 82043

The urine microalbumin level test measures the amount of a protein called albumin in your urine. This test helps to detect early signs of kidney damage. High levels of albumin may suggest your kidneys aren't functioning properly. It's a simple, non-invasive test that involves providing a urine sample.

65 services45 patients

Creatinine level to test for kidney function or muscle injury 82570

A creatinine level test measures the amount of creatinine in your blood. This substance is a waste product from normal muscle use. Higher levels can indicate possible kidney dysfunction or muscle injury. This test helps monitor kidney health.

65 services46 patients

Automated urinalysis test 81003

An automated urinalysis test is a routine examination that checks your urine for various substances. It can help identify potential health issues such as kidney problems or diabetes. The test uses a machine to analyze a small urine sample, providing quick and accurate results.

58 services49 patients

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

50 services41 patients

Hospital Affiliations CMS Care Compare 3

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Intermountain Medical Center

Acute Care Hospitals · Murray, UT

5/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number460010

Location5121 South Cottonwood StreetMurray, UT 84107 · Salt Lake County

Emergency services Birthing friendly

Holy Cross Hospital-Jordan Valley

Acute Care Hospitals · West Jordan, UT

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number460051

Location3580 West 9000 SouthWest Jordan, UT 84088 · Salt Lake County

Emergency services Birthing friendly

Riverton Hospital

Acute Care Hospitals · Riverton, UT

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number460058

Location3741 West 12600 SouthRiverton, UT 84065 · Salt Lake County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 84088 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.

Referred Medical Equipment & Supplies CMS DME claims 4

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253

DME-Other DME · category DE017N

4 suppliers18 claims54 services$5.79 avg. paid by Medicare

Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing E0431

DME-Oxygen and Supplies · category DC000N

3 suppliers23 claims24 services$15.76 avg. paid by Medicare

Nebulizer, with compressor E0570

DME-Other DME · category DE000N

1 supplier12 claims12 services$2.98 avg. paid by Medicare

Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate E1390

DME-Oxygen and Supplies · category DC002N

3 suppliers35 claims36 services$70.37 avg. paid by Medicare

Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

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Other Providers at the Same Location NPPES 8

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

MEGAN BLISS

Nurse Practitioner (Primary Care)