JESSE P. WACKERBARTH MD
NPI 1902303613
Internal Medicine in Murray, UT
About Jesse P. Wackerbarth Md NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
JESSE P. WACKERBARTH MD (NPI 1902303613) is an individual internal medicine provider in Murray, Utah, licensed in Utah (13312672-1205) and active in the NPI registry since April 2018. He is enrolled in Medicare PECOS, is affiliated with Lds Hospital, and maintains 2 additional practice locations.
NPPES Registry Identity
Specialties & Licenses 2
Secondary Practice Locations 2
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
Jesse P. Wackerbarth 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 Reassignment
Medicare enrollment records show Jesse Wackerbarth reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Murray, UT 84107
- Reassigned Medicare billing, Utah enrollment
- Also billed through NPI 1235664251 (Utah)
- 1,729 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.
Lds Hospital
Acute Care Hospitals · Salt Lake City, UTIntermountain Medical Center
Acute Care Hospitals · Murray, UTPhysician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 84107 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Medicare Quality Performance CMS QPP · MIPS
Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.
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.
SALT LAKE CITY, UT 84107
MURRAY, UT 84107
SALT LAKE CITY, UT 84107
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 Jesse Wackerbarth's NPI number?
The NPI number for Jesse Wackerbarth is 1902303613. It was assigned to this individual provider in the NPPES registry on April 9, 2018.
Where is Jesse Wackerbarth located?
Jesse Wackerbarth practices at 5121 S Cottonwood St, Murray, UT 84107. The listed phone number is (801) 507-7000.
What is Jesse Wackerbarth's specialty?
The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.
Is Jesse Wackerbarth enrolled in Medicare?
Yes. Jesse Wackerbarth 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 organization bills Medicare for Jesse Wackerbarth's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Jesse Wackerbarth reassigns Medicare benefits to Ihc Health Services, Inc. (Murray, UT). The 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 Jesse Wackerbarth's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
Is Jesse Wackerbarth affiliated with any hospitals?
According to CMS data, Jesse Wackerbarth is affiliated with Lds Hospital and Intermountain Medical Center.
When was this NPI record last updated?
The NPPES record for Jesse Wackerbarth was last updated on January 29, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 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.
# Jesse P. Wackerbarth, MD · NPI 1902303613
Internal Medicine physician in Murray, Utah. Individual provider, active in the CMS NPPES registry since April 9, 2018.
## Identity
- **NPI:** 1902303613 (Entity type: Individual)
- **Enumerated:** April 9, 2018
- **Primary specialty:** Internal Medicine · taxonomy 207R00000X
- **State license:** 13312672-1205 (Utah)
- **Sole proprietor:** No
## Practice location
- **Address:** 5121 S COTTONWOOD ST, Murray, UT 84107-5701
- **Phone:** (801) 507-7000
## 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:** Ihc Health Services, Inc. (NPI 1043220650, Murray, UT), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** University Of California, San Diego School Of Medicine, class of 2018
## Record status
- **NPPES last updated:** January 29, 2026
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Source: [NPI Profile](https://npiprofile.com/npi/1902303613) · Data from the CMS NPPES public registry.