JEFFREY M WALLENTINE (MD) – Orthopaedic Surgery Physician, NPI 1124121934
Orthopaedic Surgery Physician
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Doctor Profile
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Profile Insights
NPPES metrics only — not quality of care.
325 ORTHOPEDIC SURGERY in UT
Provider Addresses for JEFFREY M WALLENTINE (MD)
1100 S Medical Dr
MT Pleasant, UT 846472222
Phone: (801) 373-7350
Type: Location
65 E 100 N
Ste A
Gunnison, UT 84634
Phone: (801) 373-7350
Type: Location
700 W 800 N Ste 100
Orem, UT 840576301
Phone: (801) 373-7350
Type: Location
555 W SR 164
Salem, UT 84653
Phone: (801) 373-7350
Type: Location
1130 Smith Fieldhouse
Provo, UT 846022246
Phone: (801) 373-7350
Type: Location
Revere Health, 1055, North 500 West, North Park, Provo, Utah County, Utah, 84604, United States
CREDENTIALING DEPARTMENT
PROVO, UT 846043305
Phone: (801) 354-8225
Fax: (801) 418-0941
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 44 Open Payments records for all available years, with a total value of $4,058.
Total Amount is formed as General ($4,058) + Research ($0) + Ownership ($0) = $4,058.
Last reported payment date: 2024-11-07 • Largest payer in this snapshot: Active Medical, LLC ($2,282).
Total Amount
$4,058
General + Research + Ownership
Payments
44
Total payment records
General Amount
$4,058
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-11-07
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Active Medical, LLC | $2,282 |
| Arthrex, Inc. | $1,200 |
| Stryker Corporation | $356 |
| Globus Medical, Inc. | $39 |
| Boston Scientific Corporation | $34 |
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: 2004-07-12
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 |
|---|---|---|---|---|
| I20040712001081 | I | Orthopedic Surgery | UT | 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.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| J3301 | Injection, triamcinolone acetonide, not otherwise specified, 10 mg | 388 | 77 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 139 | 115 | $0 |
| 20610 | Aspiration and/or injection of fluid from large joint | 116 | 96 | $0 |
| 36415 | Insertion of needle into vein for collection of blood sample | 115 | 86 | $0 |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 113 | 103 | $0 |
Insurance plans in this area (ZIP 84647)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| ORTHOPEDIC SURGERY | UT | 27447 | Repair of knee joint | 117 | 110 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| - | UT | |
| - | UT | |
| Physical Therapist In Private Practice | UT | |
| Orthopedic Surgery | UT | |
| Nurse Practitioner | OR | |
| - | FL | |
| - | UT | |
| - | UT | |
| Nurse Practitioner | UT | |
| - | UT |
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