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KELSEY GLEASON PA-C
NPI 1205217890
Physician Assistant - Surgical in Provo, UT

Active since June 09, 2015PECOS EnrolledAccepts Medicare Assignment
1055 N 500 W STE 121, PROVO, UT 84604(801) 373-7350(801) 812-5401 Get Directions Write a Review

NPPES record last updated: November 27, 2023. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Mar 31, 2020, Jul 9, 2019, Jun 13, 2019 (3 updates tracked since 2019).

About Kelsey Gleason Pa-c NPPES

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

KELSEY GLEASON PA-C (NPI 1205217890) is an individual surgical provider in Provo, Utah, licensed in Utah (11085884-1206) and active in the NPI registry since June 2015. She is enrolled in Medicare PECOS, maintains 2 additional practice locations, and is a graduate of Other (2015).

NPPES Registry Identity

NPI1205217890
Entity TypeIndividualFemale
Primary Taxonomy363AS0400X
Provider Legal NameKELSEY GLEASONCredential: PA-C
Location Address1055 N 500 W STE 121Provo, UT 84604
Mailing Address1055 N 500 W, Att: CredentialingProvo, UT 84604-3305 · (801) 354-8225 · Fax (801) 418-0941
Phone(801) 373-7350
Fax(801) 812-5401
Sole ProprietorNo
Medical School CMSOtherGraduated 2015
Enumeration DateJune 9, 2015
Last NPPES UpdateNovember 27, 20233 updates tracked since enumeration
NPPES CertifiedMarch 31, 2020
✔ NPI 1205217890 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPhysician Assistant · SurgicalPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363AS0400X
License✔ Licensed in UT · 11085884-1206
Also ListedPhysician AssistantTaxonomy 363A00000X · License 11085884-1206 (UT)
1055 N 500 W STE 121, Provo, UT 84604
Open in Google Maps ↗

Other Names 1

Former Name (1)Kelsey Koeppel

Secondary Practice Locations 2

Location 1700 W 800 N Ste 100Orem, UT 84057-6301 · Phone (801) 373-7350 · Fax (801) 224-5337
Location 21055 N 500 W Ste 121Provo, UT 84604 · Phone (801) 373-7350 · Fax (801) 812-5401

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Oscar Health Insurance, Oscar Health Maintenance Organization of Florida, Oscar Health Plan of North Carolina, Inc and more.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

Kelsey Gleason Pa-c 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 ID2466769120
PECOS Enrollment IDI20230425001000
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.

Other Providers at the Same Location NPPES 9

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

ZACHARY DAVID GOLDEN PA
Physician Assistant
1055 N 500 W STE 121
PROVO, UT 84604
Utah County (801) 373-7350
BRADFORD K MATTHEWS MD
Orthopaedic Surgery
1055 N 500 W STE 121
PROVO, UT 84604
Utah County (801) 373-7350
DR. BENJAMIN STEVEN CROUCH D.O.
Physical Medicine & Rehabilitation
1055 N 500 W STE 121
PROVO, UT 84604
Utah County (801) 373-7350
TODD MICHAEL GILBERT M.D.
Orthopaedic Surgery
1055 N 500 W STE 121
PROVO, UT 84604
Utah County (801) 354-8225
TIMOTHY ROSS CARROLL PA-C
Physician Assistant
1055 N 500 W STE 121
PROVO, UT 84604
Utah County (801) 373-7350
JACOB CHURCH PA
Physician Assistant
1055 N 500 W STE 121
PROVO, UT 84604
Utah County (013) 737-3508
DAVID L PETERSON P.A
Physician Assistant
1055 N 500 W STE 121
PROVO, UT 84604
Utah County (801) 373-7350
DR. COLLIN C BARBER M.D.
Orthopaedic Surgery
1055 N 500 W STE 121
PROVO, UT 84604
Utah County (801) 373-7350

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 Kelsey Gleason's NPI number?

The NPI number for Kelsey Gleason is 1205217890. It was assigned to this individual provider in the NPPES registry on June 9, 2015. The provider is also known as Kelsey Koeppel.

Where is Kelsey Gleason located?

Kelsey Gleason practices at 1055 N 500 W Ste 121, Provo, UT 84604. The listed phone number is (801) 373-7350.

What is Kelsey Gleason's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Surgical, with taxonomy code 363AS0400X.

Is Kelsey Gleason enrolled in Medicare?

Yes. Kelsey Gleason 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 Kelsey Gleason accept?

Health plans from Oscar Health Insurance, Oscar Health Maintenance Organization of Florida, Oscar Health Plan of North Carolina, Inc, Oscar Health Plan, Inc. and Oscar Insurance Company and 1 other insurer list Kelsey Gleason 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.

When was this NPI record last updated?

The NPPES record for Kelsey Gleason was last updated on November 27, 2023. NPI Profile syncs with the weekly NPPES data releases published by CMS.