ALLAN JEFFERY (DO) – Internal Medicine Physician, NPI 1336212414

ALLAN JEFFERY (DO) is a healthcare provider. based in Provo, Utah. specializing in INTERNAL MEDICINE. They hold the professional credentials DO. They hold a License No. 5745854-1204 (UT). The NPI Number for ALLAN JEFFERY (DO) is 1336212414

Main info

Male
27 Years Of Experience
Accepts Medicare Assignment
Name
ALLAN JEFFERY (DO)
NPI
1336212414
Phone
(801) 354-8215
Address
1055 N 500 W
Enumeration Date
16 November 2006
Last Update Date
8 July 2007

Doctor Profile

Medical School Name
KANSAS CITY MEDICAL COLLEGE
Secondary Phone
8019212260
Graduation Year
1999 (27 years ago)
PAC ID
9335138221
Group Practice PAC ID
5799107025
Professional Enrollment ID
I20050325000247
Address ID
UT840571909OR153XX400X300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience52
Completeness75
Years active:19State licenses:1Digital endpointsOther names

903 INTERNAL MEDICINE in UT

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Provider Addresses for ALLAN JEFFERY (DO)

  • Revere Health, 1055, North 500 West, North Park, Provo, Utah County, Utah, 84604, United States

    CREDENTIALING DEPARTMENT

    PROVO, UT 846043305

    Phone: (801) 354-8215

    Fax: (801) 429-8180

    Mailing address matches the actual address.

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: 2005-03-25

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

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

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20050325000247IInternal MedicineUTTBD

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: 5799107025View full group profile
NameSpecialtyState
Nurse PractitionerUT
Nurse PractitionerUT
Nurse PractitionerUT
Nurse PractitionerUT
Nurse PractitionerUT
Nurse PractitionerUT

Reviews

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Frequently asked questions

What federal number belongs to ALLAN JEFFERY (DO)?
The federal identifier for ALLAN JEFFERY (DO) is NPI 1336212414.
Is ALLAN JEFFERY (DO)'s enrollment marked active?
An active flag here means the NPI record is not in a deactivated state.
Does ALLAN JEFFERY (DO) list a primary specialty?
If you are matching referrals, note Internal Medicine Physician for ALLAN JEFFERY (DO). Clinical services aligned with this taxonomy classification.
Where is ALLAN JEFFERY (DO)'s primary listing?
We display Provo, Utah because that is what the record indicates for ALLAN JEFFERY (DO).
What if Provo, Utah seems incomplete?
Street-level detail can be omitted — open the full address list for this NPI.

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