SCOTT ALLEN ANDELIN (MD) – Family Medicine Physician, NPI 1013245000
Family Medicine Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
1,136 FAMILY PRACTICE in UT
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Provider Addresses for SCOTT ALLEN ANDELIN (MD)
PO BOX 27128
SALT LAKE CITY, UT 841270128
Phone: (801) 387-5300
Type: Mailing
4403, Harrison Boulevard, Ogden, Weber County, Utah, 84403, United States
STE A-700
OGDEN, UT 844033271
Phone: (801) 387-5300
Type: Location
336 S Jefferson St
Neosho, MO 648501769
Phone: (417) 455-4200
Type: Location
3202 McIntosh Cir Ste 301
Joplin, MO 648043686
Phone: (417) 347-8430
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: 2012-09-14
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 |
|---|---|---|---|---|
| I20120914000102 | I | Family Practice | MO | 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 84127)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| - | MO | |
| Clinical Social Worker | MO | |
| Nurse Practitioner | MO | |
| - | MO | |
| Nurse Practitioner | MO | |
| Nurse Practitioner | MO | |
| Nurse Practitioner | MO | |
| Mental Health Counselor | MO | |
| Nurse Practitioner | MO | |
| Nurse Practitioner | MO |
Reviews
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