DR. JONATHAN MICHAEL NEILSON DNP
NPI 1780236109
Nurse Practitioner - Pediatrics in Riverton, UT
About Dr. Jonathan Michael Neilson Dnp NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
DR. JONATHAN MICHAEL NEILSON DNP (NPI 1780236109) is an individual pediatrics provider in Riverton, Utah, licensed in Utah (9523151-4405) and active in the NPI registry since July 2019. He is enrolled in Medicare PECOS and maintains a secondary practice location in West Valley City.
NPPES Registry Identity
Specialties & Licenses 5
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 (PECOS)
Dr. Jonathan Michael Neilson Dnp is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignments
3Medicare enrollment records show Jonathan Neilson reassigns Medicare billing to 3 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Riverton, UT 84065
- Reassigned Medicare billing, Utah enrollment
- 190 clinicians in this Medicare group
South Jordan, UT 84095
- Reassigned Medicare billing, Utah enrollment
- 254 clinicians in this Medicare group
West Valley City, UT 84119
- Reassigned Medicare billing, Utah enrollment
- 188 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.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 84096 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
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.
RIVERTON, UT 84096
RIVERTON, UT 84096
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 Jonathan Neilson's NPI number?
The NPI number for Jonathan Neilson is 1780236109. It was assigned to this individual provider in the NPPES registry on July 16, 2019.
Where is Jonathan Neilson located?
Jonathan Neilson practices at 12391 S 4000 W, Riverton, UT 84096. The listed phone number is (801) 302-1700.
What is Jonathan Neilson's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Pediatrics, with taxonomy code 363LP0200X.
Is Jonathan Neilson enrolled in Medicare?
Yes. Jonathan Neilson is registered in the Medicare PECOS enrollment system.
Which organizations bill Medicare for Jonathan Neilson's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Jonathan Neilson reassigns Medicare benefits to 3 organizations: Granger Medical Clinic, PC (Riverton, UT), Physician Group Of Utah Inc (South Jordan, UT) and Granger Medical Specialists LLC (West Valley 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 Jonathan Neilson's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Jonathan Neilson accept?
Health plans from BridgeSpan Health Company, Imperial Health Plan of the Southwest, Inc., Molina Healthcare, Regence BlueCross BlueShield of Utah and Select Health and 1 other insurer list Jonathan Neilson 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 Jonathan Neilson was last updated on January 23, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 21 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.
# Dr. Jonathan Michael Neilson, DNP · NPI 1780236109
Pediatrics physician in Riverton, Utah. Individual provider, active in the CMS NPPES registry since July 16, 2019.
## Identity
- **NPI:** 1780236109 (Entity type: Individual)
- **Enumerated:** July 16, 2019
- **Primary specialty:** Nurse Practitioner - Pediatrics · taxonomy 363LP0200X
- **State license:** 9523151-4405 (Utah)
- **Sole proprietor:** Yes
## Practice location
- **Address:** 12391 S 4000 W, Riverton, UT 84096-7012
- **Phone:** (801) 302-1700
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **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): Granger Medical Clinic, PC (NPI 1649541699, Riverton, UT); Physician Group Of Utah Inc (NPI 1477676930, South Jordan, UT); Granger Medical Specialists LLC (NPI 1376159368, West Valley City, UT) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** January 23, 2025
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Source: [NPI Profile](https://npiprofile.com/npi/1780236109) · Data from the CMS NPPES public registry.