Independent US Healthcare Provider Directory & Public Medical Database Patient Guides

Elizabeth J Avery , PA

Physician Assistant β€’ Provo, UT

Active NPI 1134828965 Individual Practitioner Female Practitioner Accepts Medicare assignment
Practice location in NPPES

1055 N 500 W, Ste 205, Building C
Provo, UT 846043305

Call 8014298095 Location details and other listings
Medical Disclaimer

This profile restates public CMS/NPPES data; T-MedInfo gives no medical advice — consult a licensed professional, and call 911 for emergencies.

Practice Location & Contact Primary Location

Practice Address

1055 N 500 W
Ste 205, Building C

Provo, UT 846043305

Telephone 8014298095
Fax 8013548265
Organization at the Same NPPES Address or Phone
No Roll Up Timpanogos Llc Facility NPI 1831153840

Matched by practice address or phone in NPPES. A shared address or phone does not confirm that this clinician works there.

Other Listings in Public Data

CMS Doctors and Clinicians lists 1 group name: Revere Health Pc. See the list

Source: CMS Doctors and Clinicians National Downloadable File, release date unavailable.

Listings do not confirm current availability, employment or a shared ownership network.

Medicare Profile & Education

Source: CMS Doctors and Clinicians National Downloadable File

Graduation Year

2025

Industry payments (Open Payments)

No Open Payments records are listed for this clinician for 2021–2025.

Guide: How to read an Open Payments record

Years since graduation

1 years (graduated 2025)

CMS Doctors and Clinicians data list 2025 as the year this clinician finished professional school.

What this does not show: Years since graduation

It is not the number of years in practice, and more years does not mean better care.

Source: CMS Doctors and Clinicians National Downloadable File.

NPI first issued

2023

The year this clinician's National Provider Identifier (NPI) was issued. An NPI is a unique 10-digit ID that US health care providers use for billing.

What this does not show: NPI first issued

NPIs have been issued only since 2005, so this year is not necessarily when the clinician started practicing.

Source: CMS NPPES NPI Registry.

Accepts Medicare assignment

CMS data list this clinician as accepting Medicare assignment. This means agreeing to take the Medicare-approved amount as full payment for covered services.

Medicare assignment applies to Original Medicare. It does not tell you whether the clinician is in a Medicare Advantage plan's network, accepts other insurance, or is taking new patients.

Source: CMS Doctors and Clinicians; Medicare.gov, β€œDoes your provider accept Medicare as full payment?”

Guide: What Medicare assignment means

No telehealth indicator

CMS shows this indicator only when recent Medicare claims include telehealth services. The clinician may still offer telehealth; ask the office.

Source: CMS, Telehealth Indicator on Medicare Care Compare (fact sheet, January 2023); CMS Doctors and Clinicians.

Guide: How Medicare covers telehealth

Enrolled in Medicare (PECOS)

Elizabeth Avery has a Medicare enrollment record in PECOS, the CMS system clinicians use to enroll so they can bill Medicare or order services for people with Medicare.

It does not show whether the clinician accepts assignment, is in your plan's network, or is taking new patients.

Source: CMS Medicare Fee-For-Service Public Provider Enrollment (PECOS); CMS Order and Referring file.

Guide: What Medicare enrollment (PECOS) means

Can order Medicare-covered services

CMS lists Elizabeth Avery as eligible to order or refer Medicare Part B clinical laboratory and imaging services, durable medical equipment (DME) and home health services for people with Medicare.

What this does not show: Can order Medicare-covered services

It does not mean the clinician offers these services directly.

Source: CMS Medicare Fee-For-Service Public Provider Enrollment (PECOS); CMS Order and Referring file.

Guide: What ordering and referring status means

Compared with the same specialty in Provo and Utah

147 active clinicians are listed under Physician Assistant with a practice address in Provo, UT (1,887 in Utah).

Addresses are self-reported to NPPES and may be out of date.

Telehealth indicator in Provo

19% of these 147 clinicians have the CMS telehealth indicator.

76.9% of these 147 clinicians are listed by CMS as accepting Medicare assignment.

Sources: CMS Doctors and Clinicians, CMS NPPES NPI Registry. Specialty names follow the NUCC Health Care Provider Taxonomy.

Text: T-MedInfo Β· Report an error.

Specialties & License Numbers Reported to NPPES

Self-certified to NPPES: 2025-09-17
Physician Assistant Primary Specialty

NUCC Taxonomy Code: 363A00000X

License # reported to NPPES UT 14240564-1206

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

Check License Status with the State Board License numbers are self-reported to NPPES; T-MedInfo does not confirm them against state records. Current status: Utah Division of Professional Licensing.
Look Up on State Board Site

Medicare (PECOS) Enrollment & Ordering Eligibility

Source: CMS PECOS
Medicare FFS Enrollment Status Medicare Enrollment on File
CMS Provider Specialty

PRACTITIONER - PHYSICIAN ASSISTANT

Medicare Enrollment ID

I20251126001632

Enrollment State Jurisdiction

UT

PECOS Control ID

5496247496

Medicare Order & Referring Eligibility
Clinical Lab & Imaging (Part B) Eligible
Durable Medical Equipment (DME) Eligible
Home Health Agency (HHA) Eligible
Power Mobility Devices (PMD) Eligible

Sources: CMS Provider Enrollment and Order and Referring. Medicare enrollment is a billing status, not an accreditation or quality rating.

Medicare Group Practice Enrollments

Source: CMS Doctors and Clinicians National Downloadable File

Revere Health Pc

1055 N 500, Provo, UT 846043305

Phone: 8014298095

Clinicians Sharing This Practice Address or Phone

Clinicians sharing this NPPES address, phone or fax; a shared contact does not mean they work together.

5 listed
Elizabeth Mahoney , PA

Physician Assistant

NPI 1417610890

Physician Assistant

Dr. Mohammed Nizam , MD

Internal Medicine - Endocrinology, Diabetes & Metabolism

NPI 1326203514

Doctor of Medicine (M.D.)

Rosanne Oliver , FNP

Nurse Practitioner - Family

NPI 1073903720

Family Nurse Practitioner

Leslie Putnam , APRN, FNP-C

Nurse Practitioner - Family

NPI 1922550060

Advanced Practice Registered Nurse, Family Nurse Practitioner (Certified)

Katelyn Siano

Nurse Practitioner - Family

NPI 1780209668

Career & Practice History Timeline

Changes recorded in monthly NPPES data files: addresses, names, credentials, specialties and NPI status

10 Historical Events
πŸ“
Updated Practice Location September 17, 2025

Registered at 1055 N 500 W, STE 205, BUILDING C, PROVO, UT 846043305 (Tel: 8014298095)

πŸ“
Updated Business Mailing Address September 17, 2025

Registered at 1055 N 500 W, ATT: CREDENTIALING, PROVO, UT 846043305 (Tel: 8013548226)

πŸ‘€
Provider Name / Credentials Updated September 17, 2025

Recorded as ELIZABETH AVERY, PA

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) September 17, 2025

Physician Assistant (license number reported to NPPES: UT 14240564-1206)

βœ…
NPI Profile Active March 01, 2023

NPI status registered as active in NPPES database

πŸ“
Practice Location (Initial Record) March 01, 2023

Registered at 1188 N 100 W, OREM, UT 840573113 (Tel: 8018228474)

πŸ“
Business Mailing Address (Initial Record) March 01, 2023

Registered at 1188 N 100 W, OREM, UT 840573113 (Tel: 8018228474)

πŸ‘€
Provider Name / Credentials (Initial Record) March 01, 2023

Recorded as ELIZABETH AVERY

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) March 01, 2023

Student in an Organized Health Care Education/Training Program

🟒
Initial NPI Registration & Enumeration March 01, 2023

First registered as active Individual Practitioner in NPPES Database.

No reviews have been published yet. Leave a review.

NPI Administrative Meta

NPI Number: 1134828965
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: March 01, 2023
Last Update: September 17, 2025
Sole Proprietor: Yes

Other Physician Assistants in Provo

All Physician Assistants in Provo

Mailing Address

1055 N 500 W, Att: Credentialing

Provo, UT 846043305

Phone: 8013548226

About This Data NPPES fields (address, phone, specialty, license) are self-reported and may be outdated; Medicare fields follow the CMS dataset named in each section. Correct directly at NPPES.