DR. JARED W HENRICKSEN MD
NPI 1396762480
Pediatrics - Pediatric Critical Care Medicine in Slc, UT

Q: What is Jared Henricksen's NPI number?

The NPI number for Jared Henricksen is 1396762480. It was assigned to this individual provider in the NPPES registry on July 16, 2006.

Q: What is Jared Henricksen's specialty?

The primary specialty registered for this NPI is Pediatrics, specializing in Pediatric Critical Care Medicine, with taxonomy code 2080P0203X.

Q: When was this NPI record last updated?

The NPPES record for Jared Henricksen was last updated on April 25, 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.

Active since July 16, 2006PECOS EnrolledAccepts Medicare Assignment

100 MARIO CAPECCHI DR, SLC, UT 84113(801) 662-1000 Get Directions Write a Review

NPPES record last updated: April 25, 2022. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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About Dr. Jared W Henricksen Md NPPES

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

DR. JARED W HENRICKSEN MD (NPI 1396762480) is an individual pediatric critical care medicine provider in Slc, Utah, licensed in Utah (347933-1205) and active in the NPI registry since July 2006. He is enrolled in Medicare PECOS and is a graduate of Medical College Of Wisconsin (2002).

NPPES Registry Identity

NPI1396762480

Entity TypeIndividualMale

Primary Taxonomy2080P0203X

Provider Legal NameDR. JARED W HENRICKSENCredential: MD

Location Address100 MARIO CAPECCHI DRSlc, UT 84113-1103

Mailing Address295 Chipeta Way, Po Box 581289Slc, UT 84108-1287 · (801) 587-7563

Phone(801) 662-1000

Sole ProprietorNo

Medical School CMSMedical College Of WisconsinGraduated 2002

Enumeration DateJuly 16, 2006

Last NPPES UpdateApril 25, 2022

NPPES CertifiedApril 25, 2022

✔ NPI 1396762480 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatrics · Pediatric Critical Care MedicineAllopathic & Osteopathic Physicians

Taxonomy Code2080P0203X

License✔ Licensed in UT · 347933-1205

Definition

A pediatrician expert in advanced life support for children from the term or near-term neonate to the adolescent. This competence extends to the critical care management of life-threatening organ system failure from any cause in both medical and surgical patients and to the support of vital physiological functions. This specialist may have administrative responsibilities for intensive care units and also facilitates patient care among other specialists.

100 MARIO CAPECCHI DR, Slc, UT 84113

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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

Dr. Jared W Henricksen 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 ID4587669981

PECOS Enrollment IDI20080725000300

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.

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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.

KAITLIN CARPENTER

Pediatrics