TYE BRIAN JENSEN (PA) – Physician Assistant, NPI 1245515725

TYE BRIAN JENSEN (PA) is a healthcare provider. based in Provo, Utah. specializing in Physician Assistant. They hold the professional credentials PA. They hold a License No. 8405540-1206 (UT). The NPI Number for TYE BRIAN JENSEN (PA) is 1245515725

Main info

Male
15 Years Of Experience
Accepts Medicare Assignment
Name
TYE BRIAN JENSEN (PA)
NPI
1245515725
Phone
(801) 354-8225
Address
1055 N 500 W
Enumeration Date
17 October 2011
Last Update Date
27 November 2023

Doctor Profile

Medical School Name
OTHER
Secondary Phone
-
Graduation Year
2011 (15 years ago)
PAC ID
3779757976
Group Practice PAC ID
7517868508
Professional Enrollment ID
I20111128000778

Contacts

Secure Messaging
medreview@reverehealth.com
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience52
Completeness85
Years active:14State licenses:1Other namesUpdated within 12 months

Provider Addresses for TYE BRIAN JENSEN (PA)

  • 1055 N 500 W

    ATTN: CREDENTIALING

    PROVO, UT 846043305

    Phone: (801) 354-8225

    Fax: (801) 418-0941

    Type: Mailing

  • 97 PROFESSIONAL WAY

    SUITE 2

    PAYSON, UT 846511614

    Phone: (801) 465-4896

    Fax: (801) 465-4107

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 1 Open Payments records for all available years, with a total value of $30.

Total Amount is formed as General ($30) + Research ($0) + Ownership ($0) = $30.

Last reported payment date: 2023-02-28 • Largest payer in this snapshot: ABBVIE INC. ($30).

Total Amount

$30

General + Research + Ownership

Payments

1

Total payment records

General Amount

$30

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2023-02-28

Latest reported date

Top Companies

Largest payers in this snapshot

CompanyAmount
ABBVIE INC.$30
View all Open Payments →|Open Payments Risk Radar →

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: 2011-11-28

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

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20111128000778IPhysician AssistantUTTBD

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.

Verify on CMS Revalidation Lookup Tool

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 84604)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 7517868508View full group profile

Reviews

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Frequently asked questions

What unique ID ties claims to TYE BRIAN JENSEN (PA)?
NPI 1245515725 is assigned to TYE BRIAN JENSEN (PA) under the national enumeration system.
Is TYE BRIAN JENSEN (PA)'s enrollment marked active?
An active flag here means the NPI record is not in a deactivated state.
What kind of provider is TYE BRIAN JENSEN (PA)?
The page reflects Physician Assistant for TYE BRIAN JENSEN (PA). Clinical services aligned with this taxonomy classification.
Does TYE BRIAN JENSEN (PA) practice in Utah?
You will see Provo, Utah on file for TYE BRIAN JENSEN (PA) alongside any extra practice locations.
What if Provo, Utah seems incomplete?
Street-level detail can be omitted — open the full address list for this NPI.

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