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MICHAEL K NEILSON D.O.
NPI 1306378823
Family Medicine - Sports Medicine in Provo, UT

Active since April 03, 2017PECOS EnrolledAccepts Medicare Assignment

NPPES record last updated: July 27, 2020. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Michael K Neilson D.o. NPPES

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

MICHAEL K NEILSON D.O. (NPI 1306378823) is an individual sports medicine provider in Provo, Utah, licensed in Utah (11680858-1204) and active in the NPI registry since April 2017. He is enrolled in Medicare PECOS, is affiliated with St Luke's Regional Medical Center, and is a graduate of Other (2017).

NPPES Registry Identity

NPI1306378823
Entity TypeIndividualMale
Primary Taxonomy207QS0010X
Provider Legal NameMICHAEL K NEILSONCredential: D.O.
Location Address475 W 940 NProvo, UT 84604-3301
Mailing AddressPo Box 27128Salt Lake City, UT 84127-0128 · (801) 357-7871
Phone(801) 357-7871
Sole ProprietorNo
Medical School CMSOtherGraduated 2017
Enumeration DateApril 3, 2017
Last NPPES UpdateJuly 27, 2020
NPPES CertifiedJuly 27, 2020
✔ NPI 1306378823 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyFamily Medicine · Sports MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207QS0010X
License✔ Licensed in UT · 11680858-1204
Definition
A family medicine physician that is trained to be responsible for continuous care in the field of sports medicine, not only for the enhancement of health and fitness, but also for the prevention of injury and illness. A sports medicine physician must have knowledge and experience in the promotion of wellness and the prevention of injury. Knowledge about special areas of medicine such as exercise physiology, biomechanics, nutrition, psychology, physical rehabilitation, epidemiology, physical evaluation, injuries (treatment and prevention and referral practice) and the role of exercise in promoting a healthy lifestyle are essential to the practice of sports medicine. The sports medicine physician requires special education to provide the knowledge to improve the health care of the individual engaged in physical exercise (sports) whether as an individual or in team participation.
Also ListedFamily MedicineTaxonomy 207Q00000X · License 11680858-1204 (UT)
475 W 940 N, Provo, UT 84604
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Moda Health Plan, Inc., Molina Healthcare, PacificSource Health Plans and more.Insurance ›

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

Michael K Neilson D.o. 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 ID1355612946
PECOS Enrollment IDI20210723002728
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.

Medicare Billing Reassignments

2

Medicare enrollment records show Michael Neilson reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Ihc Health Services Inc
3.6 mi
Internal Medicine
380 W 1230 N, STE 602
Provo, UT 84604
  • Reassigned Medicare billing, Utah enrollment
  • Also billed through NPI 1336273424 (Utah)
  • 3,691 clinicians in this Medicare group
NPI 1578079059 (801) 442-1853
Direct Orthopedic Care LLC
332 mi
Orthopaedic Surgery
10178 W FAIRVIEW AVE STE 101
Boise, ID 83704
  • Reassigned Medicare billing, Idaho enrollment
  • 9 clinicians in this Medicare group
NPI 1356769434 (208) 321-4000

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 6

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.

Injection, triamcinolone acetonide, not otherwise specified, 10 mg J3301
Triamcinolone acetonide is a medication used to reduce inflammation in the body. It's given as a 10 mg injection for conditions like allergies, arthritis, or skin problems. The injection helps to decrease swelling, redness, and itching.
372 services68 patients
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
203 services121 patients
Aspiration and/or injection of fluid from large joint 20610
This procedure involves using a needle to remove (aspiration) or introduce (injection) fluid into a large joint like the knee or hip. It can help diagnose conditions, relieve discomfort, or deliver medication directly to the joint.
84 services28 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.
38 services34 patients
Aspiration and/or injection of fluid large joint using ultrasound guidance 20611
This procedure involves using ultrasound technology to accurately locate a large joint, usually the knee or shoulder. A needle is then inserted to either extract fluid (aspiration) or inject medication. The ultrasound helps ensure precision and safety.
29 services24 patients
Ultrasonic guidance for needle placement 76942
Ultrasonic guidance for needle placement is a technique where sound waves create images that help accurately position the needle during procedures. This method ensures precision, minimizes discomfort, and increases safety.
14 services12 patients

Hospital Affiliations CMS Care Compare 2

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

St Luke's Regional Medical Center

Acute Care Hospitals · Boise, ID
5/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number130006
Location190 East Bannock StreetBoise, ID 83712 · Ada County
Emergency services Birthing friendly

Treasure Valley Hospital

Acute Care Hospitals · Boise, ID
OwnershipProprietary
CMS Certification Number130063
Location8800 West Emerald StreetBoise, ID 83704 · Ada County

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 84604 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
$96.35 typical visit price
range $17.23 – $135.20
Typical copayment $24.08 (range $4.30 – $33.80)
Most-billed visit code 99214
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.

MR. TYLER JASON FIELDSTED DO
Family Medicine
475 W 940 N
PROVO, UT 84604
Utah County (801) 357-7926
KARLY GARDNER DO
Family Medicine
475 W 940 N
PROVO, UT 84604
Utah County (801) 357-7930
TYSON DEKORSE M.D.
Student in an Organized Health Care Education/Training Program
475 W 940 N
PROVO, UT 84604
Utah County (801) 357-7940
SAMANTHA BENGTZEN DERZON MD
Family Medicine
475 W 940 N
PROVO, UT 84604
Utah County (801) 357-7940
EASTON E WEAVER
Student in an Organized Health Care Education/Training Program
475 W 940 N
PROVO, UT 84604
Utah County (801) 357-7930
MARK CONLEY DO
Student in an Organized Health Care Education/Training Program
475 W 940 N
PROVO, UT 84604
Utah County (801) 357-7930
DR. JASON ROBERT HERMAN D.O.
Family Medicine
475 W 940 N
PROVO, UT 84604
Utah County (801) 357-7930
MARIANGELA SANTIAGO PARRA DO
Student in an Organized Health Care Education/Training Program
475 W 940 N
PROVO, UT 84604
Utah County (801) 357-7930

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 Michael Neilson's NPI number?

The NPI number for Michael Neilson is 1306378823. It was assigned to this individual provider in the NPPES registry on April 3, 2017.

Where is Michael Neilson located?

Michael Neilson practices at 475 W 940 N, Provo, UT 84604. The listed phone number is (801) 357-7871.

What is Michael Neilson's specialty?

The primary specialty registered for this NPI is Family Medicine, specializing in Sports Medicine, with taxonomy code 207QS0010X.

Is Michael Neilson enrolled in Medicare?

Yes. Michael Neilson 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 organizations bill Medicare for Michael Neilson's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Michael Neilson reassigns Medicare benefits to 2 organizations: Ihc Health Services Inc (Provo, UT) and Direct Orthopedic Care LLC (Boise, ID). Each 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 Michael Neilson's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Michael Neilson accept?

Health plans from Moda Health Plan, Inc., Molina Healthcare, PacificSource Health Plans, Providence Health Plan and Select Health list Michael Neilson 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 Michael Neilson affiliated with any hospitals?

According to CMS data, Michael Neilson is affiliated with St Luke's Regional Medical Center and Treasure Valley Hospital.

When was this NPI record last updated?

The NPPES record for Michael Neilson was last updated on July 27, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years 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.