JONATHAN D NELSON (PA-C) – Physician Assistant, NPI 1265882070
Physician Assistant
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Profile Insights
NPPES metrics only — not quality of care.
1,971 PHYSICIAN ASSISTANT in UT
Provider Addresses for JONATHAN D NELSON (PA-C)
555 W SR 164
SALEM, UT 84653
Phone: (801) 465-4813
Fax: (801) 812-5433
Type: Location
1055 N 500 W Ste 212
Provo, UT 846043305
Phone: (801) 465-4813
Fax: (801) 812-5433
Type: Location
Revere Health, 1055, North 500 West, North Park, Provo, Utah County, Utah, 84604, United States
ATTN: CREDENTIALING
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 76 Open Payments records for all available years, with a total value of $1,882.
Total Amount is formed as General ($1,882) + Research ($0) + Ownership ($0) = $1,882.
Last reported payment date: 2024-12-12 • Largest payer in this snapshot: Mylan Specialty L.P. ($491).
Total Amount
$1,882
General + Research + Ownership
Payments
76
Total payment records
General Amount
$1,882
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-12
Latest reported date
Top Companies
Largest payers in this snapshot
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: 2017-10-25
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 |
|---|---|---|---|---|
| I20171025003561 | I | Physician Assistant | 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 |
|---|---|---|---|---|
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 38 | 38 | $0 |
| 94664 | Evaluation of use of breathing device | 22 | 22 | $0 |
| 99204 | New patient office or other outpatient visit, 45-59 minutes | 19 | 19 | $0 |
| 36415 | Insertion of needle into vein for collection of blood sample | 15 | 15 | $0 |
Insurance plans in this area (ZIP 84653)
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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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