CLARISSA L PETERSON (P.A.) – Physician Assistant, NPI 1740513324
Physician Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
1,971 PHYSICIAN ASSISTANT in UT
Provider Addresses for CLARISSA L PETERSON (P.A.)
299 E 900 S STE 101
PROVO, UT 846066107
Phone: (801) 374-9660
Type: Location
589 S State St
Provo, UT 846065056
Phone: (801) 420-2000
Type: Location
589, South State Street, Maeser, Provo, Utah County, Utah, 84606, United States
PROVO, UT 846065056
Phone: (801) 429-2000
Fax: (801) 429-2001
Type: Mailing
100 North, Downtown, Provo, Utah County, Utah, 84603, United States
PROVO, UT 846014433
Phone: (801) 374-9660
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 33 Open Payments records for all available years, with a total value of $1,163.
Total Amount is formed as General ($1,163) + Research ($0) + Ownership ($0) = $1,163.
Last reported payment date: 2024-12-24 • Largest payer in this snapshot: ABBVIE INC. ($515).
Total Amount
$1,163
General + Research + Ownership
Payments
33
Total payment records
General Amount
$1,163
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-24
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| ABBVIE INC. | $515 |
| E.R. Squibb & Sons, L.L.C. | $390 |
| Gilead Sciences, Inc. | $106 |
| Indivior Inc. | $75 |
| Braeburn Inc. | $39 |
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: 2014-09-16
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 |
|---|---|---|---|---|
| I20140916001645 | 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 |
|---|---|---|---|---|
| 90677 | Pneumococcal conjugate vaccine, 20 valent (pcv20), for intramuscular use | 11 | 11 | $0 |
Insurance plans in this area (ZIP 84606)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Nurse Practitioner | UT | |
| Nurse Practitioner | UT | |
| Nurse Practitioner | UT | |
| Nurse Practitioner | UT | |
| Nurse Practitioner | AZ | |
| Physician Assistant | UT |
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