TERRY RUSSELL VAN WORMER (PA-C) – Physician Assistant, NPI 1467439505
Physician Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
1,971 PHYSICIAN ASSISTANT in UT
Loading map...
Provider Addresses for TERRY RUSSELL VAN WORMER (PA-C)
PO BOX 337
LAYTON, UT 840410337
Phone: (801) 773-4840
Fax: (801) 525-8151
Type: Mailing
1700 West, Evergreen Farms, Layton, Davis County, Utah, 84041, United States
LAYTON, UT 840418803
Phone: (801) 773-4840
Fax: (801) 525-8151
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
Loading prescription activity...
Open Payments (CMS)
CMS reports 28 Open Payments records for all available years, with a total value of $654.
Total Amount is formed as General ($654) + Research ($0) + Ownership ($0) = $654.
Last reported payment date: 2024-12-11 • Largest payer in this snapshot: Boston Scientific Corporation ($140).
Total Amount
$654
General + Research + Ownership
Payments
28
Total payment records
General Amount
$654
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-11
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Boston Scientific Corporation | $140 |
| 180 Medical, Inc. | $77 |
| ABBVIE INC. | $70 |
| ConvaTec Inc. | $45 |
| Sumitomo Pharma America, Inc. | $45 |
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: 2008-05-28
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20080528000013 | 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 |
|---|---|---|---|---|
| Q9967 | Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml | 2,025 | 15 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 664 | 371 | $0 |
| A9576 | Injection, gadoteridol, (prohance multipack), per ml | 535 | 29 | $0 |
| 81002 | Urinalysis, manual test | 278 | 157 | $0 |
| 36415 | Insertion of needle into vein for collection of blood sample | 228 | 160 | $0 |
Insurance plans in this area (ZIP 84041)
Loading plans...
Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| PHYSICIAN ASSISTANT | UT | 81002 | Urinalysis, manual test | 322 | 162 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| Family Practice | UT | |
| Nurse Practitioner | UT | |
| Family Practice | UT | |
| - | UT | |
| Family Practice | UT | |
| Certified Registered Nurse Anesthetist (Crna) | UT | |
| Internal Medicine | UT | |
| Family Practice | UT | |
| - | CO | |
| - | 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.