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KELLY R AVERETT PA-C
NPI 1306198924
Physician Assistant in Salt Lake City, UT

Active since October 05, 2012PECOS EnrolledAccepts Medicare Assignment
1200 E 3900 S UNIT G175, SALT LAKE CITY, UT 84124(801) 268-7405(801) 268-7435 Get Directions Write a Review

NPPES record last updated: February 20, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Feb 20, 2025, Mar 6, 2022, Feb 9, 2022 (3 updates tracked since 2022).

About Kelly R Averett Pa-c NPPES

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

KELLY R AVERETT PA-C (NPI 1306198924) is an individual physician assistant in Salt Lake City, Utah, licensed in Utah (4850503-1206) and active in the NPI registry since October 2012. He is enrolled in Medicare PECOS, is affiliated with University Of Utah Hospitals And Clinics, and is a graduate of Other (2012).

NPPES Registry Identity

NPI1306198924
Entity TypeIndividualMale
Primary Taxonomy363A00000X
Provider Legal NameKELLY R AVERETTCredential: PA-C
Location Address1200 E 3900 S UNIT G175Salt Lake City, UT 84124-1300
Mailing AddressPo Box 100253Atlanta, GA 30384-0253
Phone(801) 268-7405
Fax(801) 268-7435
Sole ProprietorNo
Medical School CMSOtherGraduated 2012
Enumeration DateOctober 5, 2012
Last NPPES UpdateFebruary 20, 20253 updates tracked since enumeration
NPPES CertifiedFebruary 20, 2025
✔ NPI 1306198924 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 UT · 4850503-1206
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.
1200 E 3900 S UNIT G175, Salt Lake City, UT 84124
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Molina Healthcare, University of Utah Health Plans.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

Kelly R Averett 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 ID5496907768
PECOS Enrollment IDI20121213000042
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.

New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204
This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.
40 services40 patients
Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
40 services35 patients

Hospital Affiliations CMS Care Compare 2

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

University Of Utah Hospitals And Clinics

Acute Care Hospitals · Salt Lake City, UT
5/5 CMS rating
OwnershipGovernment - State
CMS Certification Number460009
Location50 North Medical DriveSalt Lake City, UT 84132 · Salt Lake County
Emergency services Birthing friendly

St Mark's Hospital

Acute Care Hospitals · Salt Lake City, UT
3/5 CMS rating
OwnershipProprietary
CMS Certification Number460047
Location1200 East 3900 SouthSalt Lake City, UT 84124 · Salt Lake County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 84124 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
$84.41 typical visit price
range $54.34 – $166.03
Typical copayment $21.10 (range $13.58 – $41.50)
Most-billed visit code 99203
Established Patient
$68.01 typical visit price
range $17.23 – $135.20
Typical copayment $17.00 (range $4.30 – $33.80)
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

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

ALEXA VICTORIA NICKEL APRN
Nurse Practitioner (Family)
1200 E 3900 S UNIT G175
SALT LAKE CITY, UT 84124
Salt Lake County (801) 268-7405

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 Kelly Averett's NPI number?

The NPI number for Kelly Averett is 1306198924. It was assigned to this individual provider in the NPPES registry on October 5, 2012.

Where is Kelly Averett located?

Kelly Averett practices at 1200 E 3900 S Unit G175, Salt Lake City, UT 84124. The listed phone number is (801) 268-7405.

What is Kelly Averett's specialty?

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

Is Kelly Averett enrolled in Medicare?

Yes. Kelly Averett 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 Kelly Averett accept?

Health plans from Molina Healthcare and University of Utah Health Plans list Kelly Averett 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 Kelly Averett affiliated with any hospitals?

According to CMS data, Kelly Averett is affiliated with University Of Utah Hospitals And Clinics and St Mark's Hospital.

When was this NPI record last updated?

The NPPES record for Kelly Averett was last updated on February 20, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 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.