Active NPI 1447341193 Individual Practitioner Male Practitioner

Douglas Lamar Fillmore , PA

Physician Assistant • Provo, UT

✓ Accepts Medicare Assignment

Professional Overview & Biography Verified Profile Summary

Douglas Fillmore, PA is a certified Physician Assistant practicing in Provo, UT. With approximately 25 years of clinical experience since completing medical education in 2001, Douglas Fillmore delivers high-quality medical care to the local community at 1055 N 500 W.

Douglas Fillmore is affiliated with Ihc Health Services Inc and accepts Medicare assignment.

Frequently performed procedures and clinical services include aspiration and/or injection of fluid from large joint, established patient outpatient office visit, prosthetic repair of shoulder joint, total shoulder. Full Medicare procedure pricing transparency rates and service volume details are listed on this profile.

Practice Location & Contact Primary Location

Practice Address

1055 N 500 W
Suite 121

Provo, UT 846043305

Telephone 8013737350

Fax 8018125401

Associated Practice Facility / Clinic

🏢 No Roll Up Timpanogos Llc Facility NPI 1831153840

Medicare Profile & Education

Medical School

Other

Graduation Year

2001

Medicare Assignment

✓ Accepts Assignment

Telehealth Flag

In-Person Only

Specialty Benchmarks & Practice Insights

Comparative analytics for Physician Assistant in Provo, UT

Senior Veteran Specialist (>20 Yrs)

Practitioner Clinical Experience

25 Yrs +14.9 yrs vs City Avg

City Avg: 10.1 Yrs

State Avg: 12.1 Yrs

Regional Practice Density

147 Specialists

Practicing in Provo, UT (1904 Statewide)

Telehealth Adoption Rate

19.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount

78.6% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Fillmore (25 Years) 25 Yrs

Provo Specialty Average (10.1 Years) 10.1 Yrs

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2024)

Reporting Year:

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
20610 Aspiration and/or injection of fluid from large joint	52	19	$157.00	$47.32
99213 Established patient office or other outpatient visit, typically 15 minutes	32	29	$205.00	$73.26
23472 Prosthetic repair of shoulder joint, total shoulder	23	21	$1000.00	$186.38
29827 Repair of shoulder rotator cuff using an endoscope	12	11	$717.00	$138.69

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
20610 Aspiration and/or injection of fluid from large joint	60	24	$157.67	$44.31
99213 Established patient office or other outpatient visit, typically 15 minutes	45	39	$142.22	$73.05
J1040 Injection, methylprednisolone acetate, 80 mg	25	19	$23.00	$11.75
29827 Repair of shoulder rotator cuff using an endoscope	13	13	$717.00	$138.99
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	12	12	$88.00	$42.78

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
20610 Aspiration and/or injection of fluid from large joint	37	19	$166.14	$47.15
99213 Established patient office or other outpatient visit, typically 15 minutes	23	23	$120.52	$74.03
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	23	18	$74.78	$45.79
J1040 Injection, methylprednisolone acetate, 80 mg	18	12	$21.72	$10.85
23472 Prosthetic repair of shoulder joint, total shoulder	14	14	$976.00	$189.02

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
20610 Aspiration and/or injection of fluid from large joint	48	26	$163.00	$45.78
99213 Established patient office or other outpatient visit, typically 15 minutes	26	23	$116.00	$72.77
J1040 Injection, methylprednisolone acetate, 80 mg	23	17	$23.00	$10.35
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	22	19	$69.00	$43.35
23472 Prosthetic repair of shoulder joint, total shoulder	13	13	$952.46	$192.17

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
20610 Aspiration and/or injection of fluid from large joint	54	26	$157.00	$44.81
99213 Established patient office or other outpatient visit, typically 15 minutes	39	37	$116.00	$61.98
J1040 Injection, methylprednisolone acetate, 80 mg	38	24	$23.00	$11.33
73030 X-ray of shoulder, minimum of 2 views	21	17	$62.00	$25.94
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	16	15	$69.00	$37.36
29826 Shaving of part of shoulder bone and repair of ligament using an endoscope	14	14	$409.00	$24.12
23472 Prosthetic repair of shoulder joint, total shoulder	13	12	$934.00	$199.52

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
20610 Aspiration and/or injection of fluid from large joint	88	44	$153.00	$43.99
J1040 Injection, methylprednisolone acetate, 80 mg	50	34	$22.54	$11.30
99213 Established patient office or other outpatient visit, typically 15 minutes	48	37	$116.00	$60.96
J7323 Hyaluronan or derivative, euflexxa, for intra-articular injection, per dose	39	12	$247.00	$127.39
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	21	18	$69.00	$37.36
29826 Shaving of part of shoulder bone and repair of ligament using an endoscope	12	12	$409.00	$23.24
23472 Prosthetic repair of shoulder joint, total shoulder	12	12	$953.00	$202.93

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
20610 Aspiration and/or injection of fluid from large joint	68	37	$153.00	$44.19
99213 Established patient office or other outpatient visit, typically 15 minutes	49	44	$115.00	$58.90
J1040 Injection, methylprednisolone acetate, 80 mg	41	29	$20.49	$11.65
J7323 Hyaluronan or derivative, euflexxa, for intra-articular injection, per dose	27	11	$250.89	$145.37
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	24	22	$69.00	$35.95

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
J3301 Injection, triamcinolone acetonide, not otherwise specified, 10 mg	110	20	$3.00	$1.81
27447 Replacement of knee joint, both sides of knee	65	61	$1680.43	$190.12
20610 Aspiration and/or injection of fluid from large joint	29	20	$162.00	$44.33

Medical Specialties & State Licenses

Physician Assistant Primary Specialty

NUCC Taxonomy Code: 363A00000X

State License UT 4945215-1205

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.

Additional State Medicaid & Healthcare Payer Identifiers

Commercial Insurance / Payer ID Ihc

107012276106 (UT)

Hospital & Practice Group Affiliations

Ihc Health Services Inc

1157 N 300, Provo, UT 846046124

Ihc Health Services Inc

1034 N 500, Provo, UT 846043380

Phone: 8013578310

Ihc Health Services Inc

1034 N 500, Provo, UT 846043380

Phone: 8013578879

Ihc Health Services Inc

700 S Hwy 99, Fillmore, UT 846315137

Phone: 8013574600

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

35 Associated Practitioners

Dr. Scott Evans , MD

Orthopaedic Surgery - Hand Surgery

NPI 1033435045

Doctor of Medicine (M.D.)

Dr. Evan Nielsen , MD

Orthopaedic Surgery

NPI 1043527260

Doctor of Medicine (M.D.)

Zachary Golden , PA

Physician Assistant

NPI 1053856542

Physician Assistant

Dr. Bradford Matthews , MD

Orthopaedic Surgery

NPI 1063523959

Doctor of Medicine (M.D.)

Eric Leach , PA-C

Physician Assistant

NPI 1124068739

Physician Assistant (Certified)

Dr. Jeffrey Wallentine , MD

Orthopaedic Surgery

NPI 1124121934

Doctor of Medicine (M.D.)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

6 Historical Events

✅

NPI Profile Active October 15, 2007

NPI status registered as active in NPPES database

📍

Updated Practice Location October 15, 2007

Registered at 1055 N 500 W, SUITE 121, PROVO, UT 846043305 (Tel: 8013737350)

📍

Updated Business Mailing Address October 15, 2007

Registered at 1055 N 500 W, CREDENTIALING DEPARTMENT, PROVO, UT 846043305 (Tel: 8013548215)

👤

Provider Name / Credentials Updated October 15, 2007

Recorded as DOUGLAS FILLMORE, PA

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) October 15, 2007

Physician Assistant (License #4945215-1205 in UT)

🟢

Initial NPI Registration & Enumeration September 27, 2006

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1447341193

Entity Type:

Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)

Enumeration Date: September 27, 2006

Last Update: October 15, 2007

Sole Proprietor: No

Update or Correct Profile

Mailing Address

1055 N 500 W, Credentialing Department

Provo, UT 846043305

Phone: 8013548215

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).

⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.