MS. KELLY GLORIA WYNN PA-C
NPI 1275225591
Physician Assistant in Seattle, WA

Q: What is Kelly Wynn's NPI number?

The NPI number for Kelly Wynn is 1275225591. It was assigned to this individual provider in the NPPES registry on May 24, 2023. The provider is also known as Kelly Gloria Stadelmaier Pa-C.

Q: What is Kelly Wynn's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Q: When was this NPI record last updated?

The NPPES record for Kelly Wynn was last updated on October 23, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 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.

Active since May 24, 2023PECOS EnrolledAccepts Medicare Assignment

825 EASTLAKE AVE E, SEATTLE, WA 98109(206) 520-5000 Get Directions Write a Review

NPPES record last updated: October 23, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jun 27, 2024, Nov 9, 2023, May 24, 2023 (3 updates tracked since 2023).

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About Ms. Kelly Gloria Wynn Pa-c NPPES

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

MS. KELLY GLORIA WYNN PA-C (NPI 1275225591) is an individual physician assistant in Seattle, Washington, licensed in Washington (PA61460042) and active in the NPI registry since May 2023. She is enrolled in Medicare PECOS, is affiliated with University Of Washington Medical Ctr, and maintains a secondary practice location in Seattle.

NPPES Registry Identity

NPI1275225591

Entity TypeIndividualFemale

Primary Taxonomy363A00000X

Provider Legal NameMS. KELLY GLORIA WYNNCredential: PA-C

Location Address825 EASTLAKE AVE ESeattle, WA 98109-4405

Mailing AddressPo Box 50095Seattle, WA 98145-5095 · (206) 520-5700

Phone(206) 520-5000

Sole ProprietorNo

Medical School CMSOtherGraduated 2023

Enumeration DateMay 24, 2023

Last NPPES UpdateOctober 23, 20253 updates tracked since enumeration

NPPES CertifiedOctober 23, 2025

✔ NPI 1275225591 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363A00000X

License✔ Licensed in WA · PA61460042

Definition

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.

825 EASTLAKE AVE E, Seattle, WA 98109

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Other Names 1

Former Name (1)Kelly Gloria Stadelmaier Pa-c

Secondary Practice Location 1

Location 11334 Terry AveSeattle, WA 98101-2747 · Phone (904) 710-3016

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Premera Blue Cross Blue Shield of Alaska, Providence Health Plan.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

Ms. Kelly Gloria Wynn 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 ID4789046848

PECOS Enrollment IDI20230822001272

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 2

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.

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes 99233

Follow-up hospital inpatient care per day typically involves a 35-minute check-up by your healthcare provider. This service includes monitoring your health progress, adjusting your treatment plan if needed, and answering any questions you may have about your condition or care.

182 services24 patients

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232

Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.

48 services13 patients

Hospital Affiliations CMS Care Compare

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

University Of Washington Medical Ctr

Acute Care Hospitals · Seattle, WA

3/5 CMS rating

OwnershipGovernment - State

CMS Certification Number500008

Location1959 NE Pacific St Box 356151Seattle, WA 98195 · King County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 98109 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$97.43 typical visit price

range $63.67 – $189.37

Typical copayment $24.35 (range $15.91 – $47.34)

Most-billed visit code 99203

Established Patient

$78.74 typical visit price

range $21.12 – $155.00

Typical copayment $19.68 (range $5.28 – $38.75)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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.

SANDHYA RAMANATHAN PANCH M.D.

Internal Medicine (Hematology)