KELLY MARVIN JEPPESEN (MD) – Family Medicine Physician, NPI 1568790558
Family Medicine Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
1,136 FAMILY PRACTICE in UT
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Provider Addresses for KELLY MARVIN JEPPESEN (MD)
St Charles Road, Monticello, Kings County, Prince Edward Island, Canada
MONTICELLO, UT 845350308
Phone: (435) 587-2116
Fax: (435) 587-3004
Type: Mailing
San Juan Hospital, 380, West 100 North, Monticello, San Juan County, Utah, 84535, United States
SUITE A
MONTICELLO, UT 845351054
Phone: (435) 587-5054
Fax: (435) 587-3004
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 5 Open Payments records for all available years, with a total value of $99.
Total Amount is formed as General ($99) + Research ($0) + Ownership ($0) = $99.
Last reported payment date: 2024-06-04 • Largest payer in this snapshot: ABBVIE INC. ($50).
Total Amount
$99
General + Research + Ownership
Payments
5
Total payment records
General Amount
$99
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-06-04
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| ABBVIE INC. | $50 |
| Organon LLC | $30 |
| Xeris Pharmaceuticals, Inc. | $19 |
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: 2023-03-22
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 |
|---|---|---|---|---|
| I20101101001549 | I | Family Practice | UT | TBD |
| I20230322002762 | I | Family Practice | HI | 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 |
|---|---|---|---|---|
| 99232 | Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes | 15 | 11 | $0 |
| 99233 | Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes | 14 | 11 | $0 |
Insurance plans in this area (ZIP 84535)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Family Practice | UT | |
| Physician Assistant | NC | |
| Internal Medicine | UT | |
| Nurse Practitioner | MT | |
| Internal Medicine | UT | |
| D E R M A T O L O G Y | RI | |
| Emergency Medicine | UT | |
| Internal Medicine | MA | |
| Physician Assistant | CA | |
| Physician Assistant | UT |
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