1. Home
  2. Directory
  3. Oklahoma
  4. Edmond
  5. Nurse Practitioner
  6. NPI Profile

KELLY K KOZHULENKO NP
NPI 1679237887
Nurse Practitioner - Primary Care in Edmond, OK

Active since October 25, 2021PECOS Enrolled
2409 NW 172ND CIR, EDMOND, OK 73012(405) 227-3130 Get Directions Write a Review

NPPES record last updated: October 25, 2021. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Kelly K Kozhulenko Np NPPES

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

KELLY K KOZHULENKO NP (NPI 1679237887) is an individual primary care provider in Edmond, Oklahoma, licensed in Oklahoma (205825) and active in the NPI registry since October 2021. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1679237887
Entity TypeIndividualFemale
Primary Taxonomy363LP2300X
Provider Legal NameKELLY K KOZHULENKOCredential: NP
Location Address2409 NW 172ND CIREdmond, OK 73012-0010
Mailing Address2409 Nw 172nd CirEdmond, OK 73012-0010 · (405) 227-3130
Phone(405) 227-3130
Sole ProprietorYes
Enumeration DateOctober 25, 2021
NPPES CertifiedOctober 25, 2021
✔ NPI 1679237887 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · Primary CarePhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LP2300X
License✔ Licensed in OK · 205825
2409 NW 172ND CIR, Edmond, OK 73012
Open in Google Maps ↗

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arkansas Health & Wellness, Ambetter from Sunflower Health Plan, Ambetter from Superior HealthPlan 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 (PECOS)

Kelly K Kozhulenko Np is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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 Kelly Kozhulenko reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

The Physicians Group LLC
2.4 mi
General Practice
14024 QUAIL POINTE DR
Oklahoma City, OK 73134
  • Reassigned Medicare billing, Oklahoma enrollment
  • 146 clinicians in this Medicare group
NPI 1487620381 (405) 419-8447
Integrative Medical Solutions PLLC
7.9 mi
Internal Medicine
65 S SAINTS BLVD
Edmond, OK 73034
  • Reassigned Medicare billing, Oklahoma enrollment
  • 5 clinicians in this Medicare group
NPI 1144471129 (405) 348-2323

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

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 73012 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
$82.46 typical visit price
range $53.00 – $162.61
Typical copayment $20.61 (range $13.25 – $40.65)
Most-billed visit code 99203
Established Patient
$94.27 typical visit price
range $16.68 – $132.40
Typical copayment $23.56 (range $4.17 – $33.10)
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.

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 Kozhulenko's NPI number?

The NPI number for Kelly Kozhulenko is 1679237887. It was assigned to this individual provider in the NPPES registry on October 25, 2021.

Where is Kelly Kozhulenko located?

Kelly Kozhulenko practices at 2409 NW 172nd Cir, Edmond, OK 73012. The listed phone number is (405) 227-3130.

What is Kelly Kozhulenko's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Primary Care, with taxonomy code 363LP2300X.

Is Kelly Kozhulenko enrolled in Medicare?

Yes. Kelly Kozhulenko is registered in the Medicare PECOS enrollment system.

Which organizations bill Medicare for Kelly Kozhulenko's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Kelly Kozhulenko reassigns Medicare benefits to 2 organizations: The Physicians Group LLC (Oklahoma City, OK) and Integrative Medical Solutions PLLC (Edmond, OK). 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 Kelly Kozhulenko's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Kelly Kozhulenko accept?

Health plans from Ambetter Health, Ambetter from Arkansas Health & Wellness, Ambetter from Sunflower Health Plan, Ambetter from Superior HealthPlan and Ambetter of Oklahoma list Kelly Kozhulenko 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 Kelly Kozhulenko was last updated on October 25, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.