KELLY LEAH GLICK PAC
NPI 1578817466
Physician Assistant in Dickinson, ND

Active since October 31, 2012PECOS EnrolledAccepts Medicare Assignment
73.87/100
CMS Quality Rating
2500 FAIRWAY ST, DICKINSON, ND 58601(701) 456-4200(701) 456-4545 Get Directions Write a Review

NPPES record last updated: March 15, 2017. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Mar 15, 2017, Jun 15, 2016 (2 updates tracked since 2016).

About Kelly Leah Glick Pac NPPES

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

KELLY LEAH GLICK PAC (NPI 1578817466) is an individual physician assistant in Dickinson, North Dakota, licensed in North Dakota (PAC0507) and active in the NPI registry since October 2012. She is enrolled in Medicare PECOS, is affiliated with Chi St Alexius Health, and is a graduate of Other (2012).

NPPES Registry Identity

NPI1578817466
Entity TypeIndividualFemale
Primary Taxonomy363A00000X
Provider Legal NameKELLY LEAH GLICKCredential: PAC
Location Address2500 FAIRWAY STDickinson, ND 58601-2639
Mailing Address2500 Fairway StDickinson, ND 58601-2639 · (701) 456-4200 · Fax (701) 456-4545
Fax(701) 456-4545
Sole ProprietorNo
Medical School CMSOtherGraduated 2012
Enumeration DateOctober 31, 2012
Last NPPES UpdateMarch 15, 20172 updates tracked since enumeration
NPI 1578817466 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 ND · PAC0507
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.

2500 FAIRWAY ST, Dickinson, ND 58601

Other Identifiers 4

Medicaid1452926ND
Medicare PINN718461ND
Medicare PINN722893ND
Medicaid71219ND

Accepted 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 Leah Glick Pac 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 ID8729232525
PECOS Enrollment IDI20130201000357
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.

Hospital Affiliations CMS Care Compare 2

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

Chi St Alexius Health

Acute Care Hospitals · Bismarck, ND
3/5 CMS rating
OwnershipVoluntary non-profit - Church
CMS Certification Number350002
Location900 E BroadwayBismarck, ND 58501 · Burleigh County
Emergency services Birthing friendly

Chi St Alexius Health Dickinson

Critical Access Hospitals · Dickinson, ND
OwnershipVoluntary non-profit - Church
CMS Certification Number351336
Location2500 Fairway StreetDickinson, ND 58601 · Stark County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 58601 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
$85.71 typical visit price
range $55.75 – $168.12
Typical copayment $21.42 (range $13.93 – $42.03)
Most-billed visit code 99203
Established Patient
$69.48 typical visit price
range $18.11 – $137.65
Typical copayment $17.37 (range $4.52 – $34.41)
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.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

73.87/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality55.05
Improvement Activities40
Cost95.3

Referred Medical Equipment & Supplies CMS DME claims 3

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253
DME-Other DME · category DE017N
4 suppliers20 claims31 services$5.64 avg. paid by Medicare
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate E1390
DME-Oxygen and Supplies · category DC002N
1 supplier14 claims14 services$118.85 avg. paid by Medicare
Portable oxygen concentrator, rental E1392
DME-Oxygen and Supplies · category DC002N
1 supplier14 claims14 services$38.05 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

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.

Physical Therapist
2500 FAIRWAY ST
DICKINSON, ND 58601
Physical Therapist
2500 FAIRWAY ST
DICKINSON, ND 58601
Speech-Language Pathologist
2500 FAIRWAY ST, REHAB SERVICES
DICKINSON, ND 58601
Clinic/Center (End-Stage Renal Disease (ESRD) Treatment)
2500 FAIRWAY ST
DICKINSON, ND 58601
Family Medicine
2500 FAIRWAY ST
DICKINSON, ND 58601
Emergency Medicine
2500 FAIRWAY ST
DICKINSON, ND 58601
Nurse Anesthetist, Certified Registered
2500 FAIRWAY ST
DICKINSON, ND 58601
Physician Assistant
2500 FAIRWAY ST
DICKINSON, ND 58601

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 Glick's NPI number?

The NPI number for Kelly Glick is 1578817466. It was assigned to this individual provider in the NPPES registry on October 31, 2012.

Where is Kelly Glick located?

Kelly Glick practices at 2500 Fairway St, Dickinson, ND 58601. The listed phone number is (701) 456-4200.

What is Kelly Glick's specialty?

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

Is Kelly Glick enrolled in Medicare?

Yes. Kelly Glick 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 Glick accept?

Health plans from Blue Cross Blue Shield of North Dakota, Medica and Sanford Health Plan list Kelly Glick 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 Glick affiliated with any hospitals?

According to CMS data, Kelly Glick is affiliated with Chi St Alexius Health and Chi St Alexius Health Dickinson.

When was this NPI record last updated?

The NPPES record for Kelly Glick was last updated on March 15, 2017. NPI Profile syncs with the weekly NPPES data releases published by CMS.