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Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

CODY BRAD MICKELSEN MD
NPI 1013159003
Anesthesiology in Providence, UT

Active since April 06, 2009PECOS Enrolled
560 W 465 N STE 604, PROVIDENCE, UT 84332(435) 753-1600 Get Directions Write a Review

NPPES record last updated: July 23, 2026. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jul 23, 2026, Jun 16, 2016 (2 updates tracked since 2016).

About Cody Brad Mickelsen Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

CODY BRAD MICKELSEN MD (NPI 1013159003) is an individual anesthesiology provider in Providence, Utah, licensed in Utah (9806425-1205) and active in the NPI registry since April 2009. He is enrolled in Medicare PECOS, is affiliated with Logan Regional Hospital, and is a graduate of University Of Vermont College Of Medicine (2013).

NPPES Registry Identity

NPI1013159003
Entity TypeIndividualMale
Primary Taxonomy207L00000X
Provider Legal NameCODY BRAD MICKELSENCredential: MD
Location Address560 W 465 N STE 604Providence, UT 84332-8006
Mailing Address560 W 465 N Ste 604Providence, UT 84332-8006 · (435) 753-1600
Phone(435) 753-1600
Sole ProprietorNo
Medical School CMSUniversity Of Vermont College Of MedicineGraduated 2013
Enumeration DateApril 6, 2009
Last NPPES UpdateJuly 23, 20262 updates tracked since enumeration
NPPES CertifiedJuly 23, 2026
✔ NPI 1013159003 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyAnesthesiologyAllopathic & Osteopathic Physicians
Taxonomy Code207L00000X
License✔ Licensed in UT · 9806425-1205
Definition
An anesthesiologist is trained to provide pain relief and maintenance, or restoration, of a stable condition during and immediately following an operation or an obstetric or diagnostic procedure. The anesthesiologist assesses the risk of the patient undergoing surgery and optimizes the patient's condition prior to, during and after surgery. In addition to these management responsibilities, the anesthesiologist provides medical management and consultation in pain management and critical care medicine. Anesthesiologists diagnose and treat acute, long-standing and cancer pain problems; diagnose and treat patients with critical illnesses or severe injuries; direct resuscitation in the care of patients with cardiac or respiratory emergencies, including the need for artificial ventilation; and supervise post-anesthesia recovery.
560 W 465 N STE 604, Providence, UT 84332
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Select Health.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Cody Brad Mickelsen Md is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID3173763356
PECOS Enrollment IDI20160727002395
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Anesthesia for other procedure on large bowel using an endoscope 00811
Anesthesia for an endoscopic procedure on the large bowel ensures comfort and relaxation during the procedure. You'll be given medication to make you drowsy or asleep, eliminating any discomfort. The medication can be administered through a vein or inhaled.
11 services11 patients

Hospital Affiliations CMS Care Compare 2

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Logan Regional Hospital

Acute Care Hospitals · Logan, UT
5/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number460015
Location1400 North 500 EastLogan, UT 84341 · Cache County
Emergency services Birthing friendly

Cache Valley Hospital

Acute Care Hospitals · North Logan, UT
OwnershipProprietary
CMS Certification Number460054
Location2380 North 400 EastNorth Logan, UT 84341 · Cache County
Emergency services Birthing friendly

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

JON R ROBISON M.D.
Anesthesiology
560 W 465 N STE 604
PROVIDENCE, UT 84332
Cache County (435) 753-1600
DR. MICHAEL JAMES GROVER M.D.
Anesthesiology
560 W 465 N STE 604
PROVIDENCE, UT 84332
Cache County (435) 753-1600
JOSHUA TYLER CHRISTIANSEN M.D.
Anesthesiology
560 W 465 N STE 604
PROVIDENCE, UT 84332
Cache County (435) 753-1600
JACOB ROBINSON
Anesthesiology
560 W 465 N STE 604
PROVIDENCE, UT 84332
Cache County (435) 753-1600
GREGORY J ALLRED DO
Anesthesiology
560 W 465 N STE 604
PROVIDENCE, UT 84332
Cache County (435) 753-1600
STEVEN JOHN WEBER DO
Anesthesiology
560 W 465 N STE 604
PROVIDENCE, UT 84332
Cache County (435) 753-1600
SHAWN M NELSON MD
Anesthesiology
560 W 465 N STE 604
PROVIDENCE, UT 84332
Cache County (435) 753-1600
ERIN A WELKER CRNA
Nurse Anesthetist, Certified Registered
560 W 465 N STE 604
PROVIDENCE, UT 84332
Cache County (435) 753-1600

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Cody Mickelsen's NPI number?

The NPI number for Cody Mickelsen is 1013159003. It was assigned to this individual provider in the NPPES registry on April 6, 2009.

Where is Cody Mickelsen located?

Cody Mickelsen practices at 560 W 465 N Ste 604, Providence, UT 84332. The listed phone number is (435) 753-1600.

What is Cody Mickelsen's specialty?

The primary specialty registered for this NPI is Anesthesiology with taxonomy code 207L00000X.

Is Cody Mickelsen enrolled in Medicare?

Yes. Cody Mickelsen is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Cody Mickelsen accept?

Health plans from Select Health list Cody Mickelsen as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Cody Mickelsen affiliated with any hospitals?

According to CMS data, Cody Mickelsen is affiliated with Logan Regional Hospital and Cache Valley Hospital.

When was this NPI record last updated?

The NPPES record for Cody Mickelsen was last updated on July 23, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 20 days ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.