Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Mr. Jacob C Fetzer, PA-C

Individual provider Physician Assistant · NPI 1235474172

Mr. Jacob C Fetzer, PA-C is a Physician Assistant in Salt Lake City, Utah. Qualified in 2012, 14 years ago. Practices with University of Utah Adult Services, a 1,740-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Utah.

Years since qualifying
14
Licensed in
UT
In the registry since
2012
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

30 N 1900 E Rm 4A100
Salt Lake City, UT 84132-0002
Phone: (801) 585-7676
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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 8421267-1206 (UT)

Record details

NPI number1235474172
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorNo
NPI enumeratedDecember 4, 2012
Last updated in NPPESNovember 9, 2021
Certification dateNovember 9, 2021

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2012 (14 years in practice)
Group practice University Of Utah Adult Services — 1740 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations3 on file with Medicare

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