1. Home
  2. Directory
  3. Utah
  4. Lehi
  5. Nurse Practitioner
  6. NPI Profile

JENNIFER JEANINE ELLSTROM FNP-C
NPI 1699441626
Nurse Practitioner - Family in Lehi, UT

Active since August 19, 2021PECOS Enrolled
3401 N CENTER ST STE 175, LEHI, UT 84043(801) 893-1872 Get Directions Write a Review

NPPES record last updated: August 19, 2021. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Jennifer Jeanine Ellstrom Fnp-c NPPES

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

JENNIFER JEANINE ELLSTROM FNP-C (NPI 1699441626) is an individual family provider in Lehi, Utah, licensed in Utah (12124921-4405) and active in the NPI registry since August 2021. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1699441626
Entity TypeIndividualFemale
Primary Taxonomy363LF0000X
Provider Legal NameJENNIFER JEANINE ELLSTROMCredential: FNP-C
Location Address3401 N CENTER ST STE 175Lehi, UT 84043-7502
Mailing Address1756 W Park AveRiverton, UT 84065-4701 · (801) 893-1905
Phone(801) 893-1872
Sole ProprietorNo
Enumeration DateAugust 19, 2021
NPPES CertifiedAugust 19, 2021
✔ NPI 1699441626 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
License✔ Licensed in UT · 12124921-4405
3401 N CENTER ST STE 175, Lehi, UT 84043
Open in Google Maps ↗

Other Names 1

Former Name (1)Jennifer Jeanine Carlson

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Imperial Health Plan of the Southwest, Inc..Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Jennifer Jeanine Ellstrom Fnp-c 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 Jennifer Ellstrom reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Riverton Family Health Center L L C
7.7 mi
Primary Care
1756 PARK AVE
Riverton, UT 84065
  • Reassigned Medicare billing, Utah enrollment
  • 21 clinicians in this Medicare group
NPI 1932285186 (801) 254-0309
Woundtech Of Utah, Inc.
25 mi
Infectious Disease
517 D ST
Salt Lake City, UT 84103
  • Reassigned Medicare billing, Utah enrollment
  • 12 clinicians in this Medicare group
NPI 1750922415 (954) 923-7440

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

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 84043 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.

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 Jennifer Ellstrom's NPI number?

The NPI number for Jennifer Ellstrom is 1699441626. It was assigned to this individual provider in the NPPES registry on August 19, 2021. The provider is also known as Jennifer Jeanine Carlson.

Where is Jennifer Ellstrom located?

Jennifer Ellstrom practices at 3401 N Center St Ste 175, Lehi, UT 84043. The listed phone number is (801) 893-1872.

What is Jennifer Ellstrom's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Is Jennifer Ellstrom enrolled in Medicare?

Yes. Jennifer Ellstrom is registered in the Medicare PECOS enrollment system.

Which organizations bill Medicare for Jennifer Ellstrom's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Jennifer Ellstrom reassigns Medicare benefits to 2 organizations: Riverton Family Health Center L L C (Riverton, UT) and Woundtech Of Utah, Inc. (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 Jennifer Ellstrom's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Jennifer Ellstrom accept?

Health plans from Imperial Health Plan of the Southwest, Inc. list Jennifer Ellstrom 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 Jennifer Ellstrom was last updated on August 19, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.