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

Mr. Jay Cannon Lambert, PA

Individual provider Physician Assistant · NPI 1770677478

Mr. Jay Cannon Lambert, PA is a Physician Assistant in Eagle Mountain, Utah. Qualified in 2004, 22 years ago. Practices with Revere Health PC, a 410-clinician group and accepts Medicare assignment. Licensed in Montana and Utah.

Years since qualifying
22
Licensed in
MT, UT
In the registry since
2006
Specialties on file
2
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

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Practice location Address checks out

4095 E Pony Express Pkwy Ste 1
Eagle Mountain, UT 84005-5529
Phone: (801) 429-8037
Fax: (801) 753-7476
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 9412400-1206 (UT)
Physician Assistant Taxonomy 363A00000X · Licence 413 (MT)

Record details

NPI number1770677478
Entity typeIndividual (Type 1)
GenderMale
Credentials PA
Sole proprietorNo
NPI enumeratedOctober 3, 2006
Last updated in NPPESNovember 12, 2018

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2004 (22 years in practice)
Group practice Revere Health Pc — 410 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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