JESSE DAVID JENSEN (D.O.) – Dermatology Physician, NPI 1619294337
Dermatology Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
197 DERMATOLOGY in UT
Provider Addresses for JESSE DAVID JENSEN (D.O.)
3465 S PIONEER PKWY
SUITE 1
WEST VALLEY CITY, UT 841202076
Phone: (801) 966-1403
Fax: (801) 964-6478
Type: Mailing
2376 N 400 E
STE 203
TOOELE, UT 840743413
Phone: (801) 966-1403
Fax: (801) 964-6478
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 107 Open Payments records for all available years, with a total value of $2,349.
Total Amount is formed as General ($2,349) + Research ($0) + Ownership ($0) = $2,349.
Last reported payment date: 2024-12-12 • Largest payer in this snapshot: UCB, Inc. ($485).
Total Amount
$2,349
General + Research + Ownership
Payments
107
Total payment records
General Amount
$2,349
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-12
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| UCB, Inc. | $485 |
| Merz North America, Inc. | $241 |
| SUN PHARMACEUTICAL INDUSTRIES INC. | $222 |
| Arcutis Biotherapeutics, Inc. | $218 |
| ABBVIE INC. | $210 |
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2014-12-30
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20141230002383 | I | Dermatology | UT | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 17003 | Destruction of precancer skin growth, 2-14 growths | 910 | 156 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 265 | 211 | $0 |
| 17000 | Destruction of precancer skin growth, 1 growth | 253 | 200 | $0 |
| 17110 | Destruction of skin growth, 1-14 growths | 138 | 123 | $0 |
| 11102 | Biopsy of related skin growth, first growth | 132 | 107 | $0 |
Insurance plans in this area (ZIP 84120)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Physician Assistant | UT |
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