Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Jeffrey M Wallentine, MD

Individual provider Orthopaedic Surgery Physician · NPI 1124121934

Jeffrey M Wallentine, MD is an Orthopedic Surgery in Provo, Utah. Graduated from University of Utah School of Medicine in 1992, 34 years ago. Practices with Revere Health PC, a 410-clinician group, works from 6 locations and accepts Medicare assignment. Licensed in Utah.

Years since qualifying
34
Trained at
University of Utah School of Medicine
Licensed in
UT
In the registry since
2006
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

1055 N 500 W Ste 121
Provo, UT 84604-3305
Phone: (801) 373-7350
Fax: (801) 812-5401
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (5)

  • 65 E 100 N, Gunnison, UT 84634 — (801) 373-7350
  • 1100 S Medical Dr, Mt Pleasant, UT 84647-2222 — (801) 373-7350
  • 700 W 800 N Ste 100, Orem, UT 84057-6301 — (801) 373-7350
  • 1130 Smith Fieldhouse, Provo, UT 84602-2246 — (801) 373-7350
  • 555 W Sr 164, Salem, UT 84653 — (801) 373-7350

Specialties & licences

Orthopaedic Surgery Physician (primary) Taxonomy 207X00000X · Licence 356423-1205 (UT)

Record details

NPI number1124121934
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedSeptember 7, 2006
Last updated in NPPESNovember 27, 2023
Certification dateFebruary 13, 2020
Mailing address1055 N 500 W, Credentialing Department, Provo, UT 84604-3305

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyORTHOPEDIC SURGERY
Medical schoolUNIVERSITY OF UTAH SCHOOL OF MEDICINE
Graduated 1992 (34 years in practice)
Group practice Revere Health Pc — 410 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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