JEFFERY GRANT TAYLOR (MPAS, PA-C) – Physician Assistant, NPI 1366773376
Physician Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
551 PHYSICIAN ASSISTANT in AK
Provider Addresses for JEFFERY GRANT TAYLOR (MPAS, PA-C)
6 HUMPHREYS ST
FORT LEONARD WOOD, MO 654731402
Phone: (719) 352-5383
Type: Mailing
7033 E TUDOR RD
ANCHORAGE, AK 995071262
Phone: (907) 729-6801
Fax: (907) 729-5180
Type: Mailing
4320 DIPLOMACY DR
ANCHORAGE, AK 995085925
Phone: (907) 729-3300
Type: Location
1086 Jaylee Dr Unit 1
Rigby, ID 834424983
Phone: (719) 352-5383
Fax: (907) 205-5962
Type: Location
126 Missouri Ave
Fort Leonard Wood, MO 654738952
Phone: (573) 596-1509
Type: Location
508 Upland St
Kenai, AK 996118026
Phone: (907) 335-7500
Type: Location
Fort Leonard Wood, Pulaski County, Missouri, 65473, United States
FORT LEONARD WOOD, MO 654738952
Phone: (573) 596-1509
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
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: 2024-06-04
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 2 Medicare enrollment records; no due dates published yet.
Enrollment records
2
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 |
|---|---|---|---|---|
| I20231222000593 | I | Physician Assistant | TX | TBD |
| I20240604003688 | I | Physician Assistant | AK | 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.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 65473)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Family Practice | AK | |
| - | AK | |
| Internal Medicine | NY | |
| - | AK | |
| Diagnostic Radiology | NC | |
| Nurse Practitioner | AK | |
| Family Practice | AK | |
| A N E S T H E S I O L O G Y | IN | |
| A N E S T H E S I O L O G Y | WA | |
| Certified Nurse Midwife (Cnm) | AK |
Reviews
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