Douglas A Allen, D.O.

Key facts

NPI

1659575686

Entity type

Individual (NPI type 1)

Primary specialty

Obstetrics Physician 207VX0000X

License

315745-1204 (UT)

Practice address

1886 West 800 North
Pleasant Grove, UT 84062-4097

Phone

(801) 756-5288

Fax

(801) 756-7589

NPI assigned

Jun 13, 2007

Sex

Male

Sole proprietor

No

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Revere Health PC Multi-Specialty Clinic/Center · Provo, UT · NPI 1093764805
  Medicare reassignment Care Compare group NPD UT
• Revere Health PC Orthopaedic Surgery Physician · Saratoga Springs, UT · NPI 1538867999
  Care Compare group
• Revere Health PC Orthopaedic Surgery Physician · Orem, UT · NPI 1780017954
  Care Compare group
• Revere Health PC Orthopaedic Surgery Physician · American Fork, UT · NPI 1891813960
  Care Compare group
• Revere Health PC Pharmacist · Provo, UT · NPI 1922156884
  Care Compare group
• Revere Health PC Multi-Specialty Clinic/Center · Spanish Fork, UT · NPI 1851142285
  NPD

Medicare Care Compare profile

Specialty

Obstetrics/Gynecology

Education

Kansas City University of Physicians and Surgeons, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Revere Health PC (407 clinicians)

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare participation

Medicare fee-for-service enrollment

Enrolled in UT

Eligible to order & refer

Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes

Medicare enrollment records

National Provider Directory

Medicare enrollment (NPD)

Yes

Credentials

Doctor of Osteopathy

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: douglasallen@cuccu.allscriptsdirect.net

Specialties & licenses

Addresses

Electronic endpoints

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Nov 27, 2023.

{
    "created_epoch": "1181692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701043200000",
    "number": "1659575686",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1055 N 500 W",
            "address_2": "ATTN: CREDENTIALING",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "846043305",
            "telephone_number": "801-354-8225",
            "fax_number": "801-418-0941"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1886 WEST 800 NORTH",
            "city": "PLEASANT GROVE",
            "state": "UT",
            "postal_code": "840624097",
            "telephone_number": "801-756-5288",
            "fax_number": "801-756-7589"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALLEN",
        "first_name": "DOUGLAS",
        "middle_name": "A",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-13",
        "last_updated": "2023-11-27",
        "certification_date": "2020-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VX0000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Obstetrics",
            "state": "UT",
            "license": "315745-1204",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "medreview@reverehealth.com",
            "affiliation": "Y",
            "affiliationName": "Revere Health PC",
            "address_1": "1886 West 800 North",
            "city": "Pleasant Grove",
            "state": "UT",
            "country_code": "US",
            "postal_code": "840624097",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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All providers in Pleasant Grove, UT · Obstetrics Physician in Utah