JACOB LAMAR PUGH (PA-C) – Physician Assistant, NPI 1396227146
Physician Assistant
Main info
Doctor Profile
Contacts
Profile Insights
NPPES metrics only — not quality of care.
1,971 PHYSICIAN ASSISTANT in UT
Loading map...
Provider Addresses for JACOB LAMAR PUGH (PA-C)
1055 NORTH 500 WEST
ATTN: CREDENTIALING
PROV, UT 846043305
Phone: (801) 354-8225
Fax: (801) 418-0941
Type: Mailing
5640, South 3500 West, Roy, Weber County, Utah, 84067, United States
ROY, UT 840679158
Phone: (801) 773-2838
Fax: (801) 773-3025
Type: Location
2432 CONCORD AVE
SANTA CLARA, UT 847655621
Phone: (435) 429-0944
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
Loading prescription activity...
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: 2022-03-15
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 2 Medicare enrollment records; no due dates published yet.
Enrollment records
2
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 |
|---|---|---|---|---|
| I20180919003213 | I | Physician Assistant | UT | TBD |
| I20220315001206 | I | Physician Assistant | NV | 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 |
|---|---|---|---|---|
| J1100 | Injection, dexamethasone sodium phosphate, 1 mg | 1,739 | 141 | $0 |
| J0696 | Injection, ceftriaxone sodium, per 250 mg | 909 | 190 | $0 |
| J1885 | Injection, ketorolac tromethamine, per 15 mg | 595 | 151 | $0 |
| 96372 | Injection of drug or substance under skin or into muscle | 453 | 235 | $0 |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 371 | 294 | $0 |
Insurance plans in this area (ZIP 84604)
Loading plans...
Group practice members
| Name | Specialty | State |
|---|---|---|
| Nurse Practitioner | NV | |
| - | NV | |
| Physician Assistant | NV | |
| Physician Assistant | NV | |
| Physician Assistant | NV | |
| Physician Assistant | UT | |
| Physician Assistant | UT |
Reviews
All reviews are moderated before publication. Reviews reflect users' opinions; we do not verify the accuracy of individual reviews.
No reviews yet. Be the first to share your experience — your opinion helps families compare providers.