TYSON R. JERGENSEN MD
NPI 1366071227
Anesthesiology - Pain Medicine in Salt Lake City, UT
About Tyson R. Jergensen Md NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
TYSON R. JERGENSEN MD (NPI 1366071227) is an individual pain medicine provider in Salt Lake City, Utah, licensed in Utah (12404285-1205) and active in the NPI registry since April 2020. He is enrolled in Medicare PECOS, is affiliated with University Of Utah Hospitals And Clinics, and maintains a secondary practice location in Layton.
NPPES Registry Identity
Specialties & Licenses
Secondary Practice Location 1
Accepted 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
Tyson R. Jergensen 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.
Medicare Billing Reassignments
3Medicare enrollment records show Tyson Jergensen reassigns Medicare billing to 3 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Salt Lake City, UT 84132
- Reassigned Medicare billing, Utah enrollment
- 2,620 clinicians in this Medicare group
Murray, UT 84107
- Reassigned Medicare billing, Utah enrollment
- 270 clinicians in this Medicare group
Layton, UT 84041
- Reassigned Medicare billing, Utah enrollment
- 15 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Hospital Affiliations CMS Care Compare 2
Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.
University Of Utah Hospitals And Clinics
Acute Care Hospitals · Salt Lake City, UTHoly Cross Hospital-Davis
Acute Care Hospitals · Layton, UTOther Providers at the Same Location NPPES 20
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
SALT LAKE CITY, UT 84132
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 Tyson Jergensen's NPI number?
The NPI number for Tyson Jergensen is 1366071227. It was assigned to this individual provider in the NPPES registry on April 3, 2020.
Where is Tyson Jergensen located?
Tyson Jergensen practices at 50 N Medical Dr, Salt Lake City, UT 84132. The listed phone number is (801) 581-3622.
What is Tyson Jergensen's specialty?
The primary specialty registered for this NPI is Anesthesiology, specializing in Pain Medicine, with taxonomy code 207LP2900X.
Is Tyson Jergensen enrolled in Medicare?
Yes. Tyson Jergensen 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 organizations bill Medicare for Tyson Jergensen's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Tyson Jergensen reassigns Medicare benefits to 3 organizations: University Of Utah Adult Services (Salt Lake City, UT), Tanner Memorial Clinic (Murray, UT) and North Davis Anesthesiology LLC (Layton, 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 Tyson Jergensen's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Tyson Jergensen accept?
Health plans from Ambetter Health, Ambetter Health of Delaware, Ambetter from NH Healthy Families, Ambetter from Sunflower Health Plan and BridgeSpan Health Company and 2 other insurers list Tyson Jergensen 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.
Is Tyson Jergensen affiliated with any hospitals?
According to CMS data, Tyson Jergensen is affiliated with University Of Utah Hospitals And Clinics and Holy Cross Hospital-Davis.
When was this NPI record last updated?
The NPPES record for Tyson Jergensen was last updated on May 18, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.
# Tyson R. Jergensen, MD · NPI 1366071227
Pain Medicine physician in Salt Lake City, Utah. Individual provider, active in the CMS NPPES registry since April 3, 2020.
## Identity
- **NPI:** 1366071227 (Entity type: Individual)
- **Enumerated:** April 3, 2020
- **Primary specialty:** Anesthesiology - Pain Medicine · taxonomy 207LP2900X
- **State license:** 12404285-1205 (Utah)
- **Sole proprietor:** No
## Practice location
- **Address:** 50 N MEDICAL DR, Salt Lake City, UT 84132-0001
- **Phone:** (801) 581-3622
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** 3 organizations under Medicare reassignment (form CMS-855R): University Of Utah Adult Services (NPI 1093119893, Salt Lake City, UT); Tanner Memorial Clinic (NPI 1104356013, Murray, UT); North Davis Anesthesiology LLC (NPI 1679525901, Layton, UT) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** University Of Texas Medical School At San Antonio, class of 2020
## Record status
- **NPPES last updated:** May 18, 2026
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Source: [NPI Profile](https://npiprofile.com/npi/1366071227) · Data from the CMS NPPES public registry.