Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of October 4, 2026.
NPIDirectory

Jacob Stout

Individual provider Physician Assistant · NPI 1952037939

Jacob Stout is a Physician Assistant in South Salt Lake, Utah. Qualified in 2023, 3 years ago. Practices with Santibanez PAC Utah, a 24-clinician group and accepts Medicare assignment. Licensed in Utah.

Years since qualifying
3
Licensed in
UT
In the registry since
2022
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Practice location Address checks out

2472 S 300 E
South Salt Lake, UT 84115-2895
Phone: (801) 783-5011
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 13593511-1206 (UT)

Record details

NPI number1952037939
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedAugust 1, 2022
Last updated in NPPESNovember 1, 2023
Certification dateNovember 1, 2023

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2023 (3 years in practice)
Group practice Santibanez Pac Utah — 24 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Medicare patients and services, 2024

From the CMS Medicare Physician & Other Practitioners file for calendar year 2024. It counts Original Medicare patients only, so a practice that mostly sees Medicare Advantage or privately insured patients looks smaller here than it is.

Medicare patients172
Services billed 1,087 a service is one billed item, such as a visit, a test or a procedure
Average patient age71

Dollar amounts are not shown. What Medicare pays a practice is gross billings, before staff, premises and tax and including the cost of any drugs it administers, so it is not what a clinician earns.

Colleagues at Santibanez PAC Utah

Clinicians the CMS Doctors & Clinicians file lists under the same group practice. CMS counts 24 clinicians in the practice; 11 are shown here.

Other providers in South Salt Lake