Individual provider Active NPI

Douglas A Allen, D.O.

  • Obstetrics Physician
  • Pleasant Grove, UT
National Provider Identifier
1659575686
Registry record updated Nov 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics PhysicianTaxonomy code 207VX0000X
License
315745-1204 Issued in 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
Last updated
Nov 27, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics Physician 207VX0000X 315745-1204 UT Primary

Addresses

Primary practice location

1886 West 800 North
Pleasant Grove, UT 84062-4097

Mailing address

1055 N 500 W
Attn: Credentialing
Provo, UT 84604-3305
Phone (801) 354-8225

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address medreview@reverehealth.com Revere Health PC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070802000348 UT Practitioner - Obstetrics/Gynecology 3072604214 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
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 PCGroup PAC ID 7517868508, 407 clinicians

Practice addresses (Care Compare)

1886 W 800
Pleasant Grove, UT 84062-4097
Phone (801) 756-5288

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of the uterus1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
Revere Health PC CurrentSince Dec 1, 2009 Accepting new patients
Revere Health PC CurrentSince Dec 1, 2009 Accepting new patients

Locations

4095 E Pony Express Pkwy
Ste 1
Eagle Mountain, UT 84005
Phone (801) 429-8037

3000 N Triumph Blvd
Lehi, UT 84043
Phone (385) 345-3000

1886 W 800 N
Pleasant Grv, UT 84062
Phone (801) 756-5288

1055 N 500 W
Provo, UT 84604
Phone (801) 429-8000

1055 N 500 W
Ste 212
Provo, UT 84604
Phone (801) 374-2362

1022 N Redwood Rd
Unit 101
Saratoga Springs, UT 84045
Phone (801) 756-5288

Interoperability endpoints

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

Organizations & group practices 2

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

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "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": []
}

Other providers in Pleasant Grove, UT

Sources for this page

Verify at the official NPI Registry.