KYLEE PROVOST DNP
NPI 1104789163
Nurse Practitioner in Pueblo, CO
About Kylee Provost Dnp NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
KYLEE PROVOST DNP (NPI 1104789163) is an individual nurse practitioner in Pueblo, Colorado, licensed in Colorado (APN.1001449-NP) and active in the NPI registry since December 2025. She is enrolled in Medicare PECOS and is a graduate of Other (2025).
NPPES Registry Identity
Specialties & Licenses
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Kylee Provost Dnp 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.
Medicare Billing Reassignment
Medicare enrollment records show Kylee Provost reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Walsenburg, CO 81089
- Reassigned Medicare billing, Colorado enrollment
- Also billed through NPI 1164835419 (Colorado), NPI 1346403375 (Colorado), NPI 1154799526 (Colorado), NPI 1760851737 (Colorado)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 81003 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
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.
PUEBLO, CO 81003
PUEBLO, CO 81003
PUEBLO, CO 81003
PUEBLO, CO 81003
PUEBLO, CO 81003
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 Kylee Provost's NPI number?
The NPI number for Kylee Provost is 1104789163. It was assigned to this individual provider in the NPPES registry on December 6, 2025.
Where is Kylee Provost located?
Kylee Provost practices at 1600 N Grand Ave, Pueblo, CO 81003. The listed phone number is (719) 546-2500.
What is Kylee Provost's specialty?
The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.
Is Kylee Provost enrolled in Medicare?
Yes. Kylee Provost 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.
Which organization bills Medicare for Kylee Provost's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Kylee Provost reassigns Medicare benefits to Huerfano County Hospital District (Walsenburg, CO). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Kylee Provost's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
When was this NPI record last updated?
The NPPES record for Kylee Provost was last updated on December 6, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 months 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.
# Kylee Provost, DNP · NPI 1104789163
Nurse Practitioner physician in Pueblo, Colorado. Individual provider, active in the CMS NPPES registry since December 6, 2025.
## Identity
- **NPI:** 1104789163 (Entity type: Individual)
- **Enumerated:** December 6, 2025
- **Primary specialty:** Nurse Practitioner · taxonomy 363L00000X
- **State license:** APN.1001449-NP (Colorado)
- **Sole proprietor:** Yes
## Practice location
- **Address:** 1600 N GRAND AVE, Pueblo, CO 81003-2700
- **Phone:** (719) 546-2500
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** Huerfano County Hospital District (NPI 1982612065, Walsenburg, CO), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2025
## Record status
- **NPPES last updated:** December 6, 2025
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Source: [NPI Profile](https://npiprofile.com/npi/1104789163) · Data from the CMS NPPES public registry.