PENNY JEAN PEACOCK (M.D.) – Internal Medicine Physician, NPI 1902864762
Internal Medicine Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
903 INTERNAL MEDICINE in UT
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Provider Addresses for PENNY JEAN PEACOCK (M.D.)
Ute Boulevard, Kimball Junction, Summit County, Utah, United States
205
PARK CITY, UT 840987500
Phone: (435) 655-3309
Fax: (435) 655-3392
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)
CMS reports 18 Open Payments records for all available years, with a total value of $344.
Total Amount is formed as General ($344) + Research ($0) + Ownership ($0) = $344.
Last reported payment date: 2024-11-13 • Largest payer in this snapshot: ABBVIE INC. ($132).
Total Amount
$344
General + Research + Ownership
Payments
18
Total payment records
General Amount
$344
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-11-13
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| ABBVIE INC. | $132 |
| Dexcom, Inc. | $37 |
| Astellas Pharma US Inc | $36 |
| Medtronic, Inc. | $26 |
| 180 Medical, Inc. | $23 |
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: 2003-11-11
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 |
|---|---|---|---|---|
| I20031111000328 | I | Internal Medicine | 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.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 84098)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| General Surgery | AK | |
| Pediatric Medicine | UT | |
| Physician Assistant | UT | |
| Family Practice | UT | |
| Nurse Practitioner | UT | |
| P A T H O L O G Y | IL | |
| Family Practice | UT | |
| Nurse Practitioner | UT | |
| O B S T E T R I C S/ G Y N E C O L O G Y | UT | |
| Physician Assistant | UT |
Reviews
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