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Active NPI 1366024390 Individual Practitioner Female Practitioner

Katrien Jack , PA-C

Physician Assistant • Roy, UT

✓ Accepts Medicare Assignment

Professional Overview & Biography Verified Profile Summary

Katrien Jack, PA-C is a certified Physician Assistant practicing in Roy, UT. With approximately 4 years of clinical experience since graduating from University Of Utah School Of Medicine in 2022, Katrien Jack delivers high-quality medical care to the local community at 1915 W 5950 S.

Katrien Jack maintains professional affiliations with Ihc Health Services Inc, Ogden Clinic Specialty Services Llc and accepts Medicare assignment.

Frequently performed procedures and clinical services include established patient outpatient office visit, visit complexity inherent to evaluation and management associated with medical care services that serve as the continuing focal point for all needed health care services and/or with medical care services that are part of ongoing care related to a patient's, new patient outpatient office visit. Full Medicare procedure pricing transparency rates and service volume details are listed on this profile.

Practice Location & Contact Primary Location

Practice Address

1915 W 5950 S

Roy, UT 840671454

Telephone 8013878100
Associated Practice Facility / Clinic
🏢 Ihc Health Services Inc Facility NPI 1235246497

Medicare Profile & Education

Medical School

University Of Utah School Of Medicine

Graduation Year

2022

Medicare Assignment

✓ Accepts Assignment

Telehealth Flag

In-Person Only

Specialty Benchmarks & Practice Insights

Comparative analytics for Physician Assistant in Roy, UT

Rising Specialist (<5 Yrs)
Practitioner Clinical Experience
4 Yrs -5.0 yrs vs City Avg
City Avg: 9.0 Yrs
State Avg: 12.1 Yrs
Regional Practice Density
13 Specialists

Practicing in Roy, UT (1904 Statewide)

Telehealth Adoption Rate
7.7% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
44.3% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Jack (4 Years) 4 Yrs
Roy Specialty Average (9.0 Years) 9.0 Yrs

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2024)
Reporting Year:
HCPCS Code & Description Services Patients Submitted Charge Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more
127 62 $182.00 $102.62
G2211 Visit complexity inherent to evaluation and management associated with medical care services that serve as the continuing focal point for all needed health care services and/or with medical care services that are part of ongoing care related to a patient's
98 52 $24.00 $13.34
99215 Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more
58 46 $255.00 $144.28
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more
28 28 $254.00 $135.06
99213 Established patient office or other outpatient visit, typically 15 minutes
23 21 $133.00 $73.08
99205 New patient office or other outpatient visit with a high level of medical decision making, if using time, 60 minutes or more
11 11 $312.00 $178.20

Medical Specialties & State Licenses

CMS Verified: 2025-11-21
Physician Assistant Primary Specialty

NUCC Taxonomy Code: 363A00000X

State License UT 13028685-1206

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

Hospital & Practice Group Affiliations

Ihc Health Services Inc

1915 W 5950, Roy, UT 840671454

Phone: 8013878100

Ogden Clinic Specialty Services Llc

4700 Harrison Blvd, Ogden, UT 844034303

Phone: 8014753300

Ogden Clinic Specialty Services Llc

4650 Harrison Blvd, Ogden, UT 844034303

Phone: 8014753482

Secondary Practice Locations

1351 W 200 N

Kaysville, UT 84037

Phone: 8013833420

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

19 Associated Practitioners
Dr. Kurtis Ellis , MD

Family Medicine

NPI 1013150218

Doctor of Medicine (M.D.)

Dr. Jared Hiatt , DO

Family Medicine

NPI 1093155988

Doctor of Osteopathic Medicine (D.O.)

Dr. Brent Wallace , MD

Family Medicine

NPI 1124136221

Doctor of Medicine (M.D.)

Richard Russell , PA

Physician Assistant

NPI 1184647786

Physician Assistant

Dr. John Wood , MD

Family Medicine

NPI 1184732273

Doctor of Medicine (M.D.)

Nicholas Biggs , PA-C

Physician Assistant

NPI 1225791114

Physician Assistant (Certified)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

13 Historical Events
📍
Updated Practice Location November 21, 2025

Registered at 1915 W 5950 S, ROY, UT 840671454 (Tel: 8013878100)

📍
Updated Business Mailing Address November 21, 2025

Registered at PO BOX 27128, SALT LAKE CITY, UT 841270128

📍
Updated Practice Location March 11, 2025

Registered at 1351 W 200 N, KAYSVILLE, UT 84037 (Tel: 8013833420)

📍
Updated Practice Location September 15, 2023

Registered at 1916 N 700 W STE 250, LAYTON, UT 840415723 (Tel: 8014790312)

📍
Updated Business Mailing Address September 15, 2023

Registered at PO BOX 5546, DENVER, CO 802175546 (Tel: 8014753500)

👤
Provider Name / Credentials Updated September 15, 2023

Recorded as KATRIEN JACK, PA-C

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) December 11, 2022

Physician Assistant (License #13028685-1206 in UT)

NPI Profile Active April 28, 2021

NPI status registered as active in NPPES database

📍
Updated Practice Location April 28, 2021

Registered at 652 S 600 E APT 7, ST GEORGE, UT 847703762 (Tel: 4353132317)

📍
Updated Business Mailing Address April 28, 2021

Registered at 652 S 600 E APT 7, ST GEORGE, UT 847703762 (Tel: 4353132317)

👤
Provider Name / Credentials Updated April 28, 2021

Recorded as KATRIEN JACK

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) April 28, 2021

Student in an Organized Health Care Education/Training Program

🟢
Initial NPI Registration & Enumeration April 28, 2021

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1366024390
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: April 28, 2021
Last Update: November 21, 2025
Sole Proprietor: No

Mailing Address

Po Box 27128

Salt Lake City, UT 841270128

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.