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SELENE INGRAHAM APRN
NPI 1780577189
Nurse Practitioner - Family in Provo, UT

Active since June 03, 2025PECOS EnrolledAccepts Medicare Assignment
1055 N 500 W, STE 201 BLDG C, PROVO, UT 84604(801) 429-8000(801) 429-8150 Get Directions Write a Review

NPPES record last updated: June 20, 2025. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Jun 20, 2025, Jun 3, 2025 (2 updates tracked since 2025).

About Selene Ingraham Aprn NPPES

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

SELENE INGRAHAM APRN (NPI 1780577189) is an individual family provider in Provo, Utah, licensed in Utah (8513908-4405) and active in the NPI registry since June 2025. She is enrolled in Medicare PECOS, maintains a secondary practice location in Spanish Fork, and is a graduate of Other (2024).

NPPES Registry Identity

NPI1780577189
Entity TypeIndividualFemale
Primary Taxonomy363LF0000X
Provider Legal NameSELENE INGRAHAMCredential: APRN
Location Address1055 N 500 W, STE 201 BLDG CProvo, UT 84604
Mailing Address1055 N 500 W, Attn CredentialingProvo, UT 84604 · (801) 354-8225 · Fax (801) 418-0941
Phone(801) 429-8000
Fax(801) 429-8150
Sole ProprietorYes
Medical School CMSOtherGraduated 2024
Enumeration DateJune 3, 2025
Last NPPES UpdateJune 20, 20252 updates tracked since enumeration
NPPES CertifiedJune 20, 2025
✔ NPI 1780577189 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
License✔ Licensed in UT · 8513908-4405
1055 N 500 W, Provo, UT 84604
Open in Google Maps ↗

Secondary Practice Location 1

Location 1221 S 2800 ESpanish Fork, UT 84660-6514 · Phone (801) 669-4656

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include BridgeSpan Health Company, Molina Healthcare, Regence BlueCross BlueShield of Utah.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

Selene Ingraham Aprn 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 ID4385158815
PECOS Enrollment IDI20250708002003
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

3

Medicare enrollment records show Selene Ingraham reassigns Medicare billing to 3 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Revere Health PC
5.6 mi
Multi-Specialty
1055 N 500 W
Provo, UT 84604
  • Reassigned Medicare billing, Utah enrollment
  • 414 clinicians in this Medicare group
NPI 1093764805 (801) 429-8000
Wasatch Healthcare Group PLLC
16 mi
Integrative Medicine
579 S 2150 W
Lehi, UT 84043
  • Reassigned Medicare billing, Utah enrollment
  • 2 clinicians in this Medicare group
NPI 1659253961 (813) 451-7731
Ma Bo Inc
37 mi
Family Medicine
466 E 500 S STE 200
Salt Lake City, UT 84111
  • Reassigned Medicare billing, Utah enrollment
  • 27 clinicians in this Medicare group
NPI 1588185581 (801) 485-5055

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 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.

ASHLEY SAUNDERS
Family Medicine
1055 N 500 W
PROVO, UT 84604
Utah County (801) 812-5033
CRYSTAL C HUFFAKER FNP
Nurse Practitioner (Family)
1055 N 500 W, STE 211, BUILDING C
PROVO, UT 84604
Utah County (801) 357-7327
SCOTT DELAFIELD EVANS MD
Orthopaedic Surgery (Hand Surgery)
1055 N 500 W, STE 121, BUILDING C
PROVO, UT 84604
Utah County (801) 373-7350
EVAN SCOTT NIELSEN MD
Orthopaedic Surgery
1055 N 500 W, STE 121
PROVO, UT 84604
Utah County (801) 373-7350
ROSANNE JOHNSON OLIVER FNP
Nurse Practitioner (Family)
1055 N 500 W, STE 205
PROVO, UT 84604
Utah County (801) 429-8095
LESLEE RONALD ADAMS NP
Nurse Practitioner (Family)
1055 N 500 W, STE 211
PROVO, UT 84604
Utah County (801) 357-7327
WYATT JAMES BOLES DO
Family Medicine
1055 N 500 W, BLDG A
PROVO, UT 84604
Utah County (801) 812-5033
DR. REX F RIPPLINGER MD
Internal Medicine
1055 N 500 W
PROVO, UT 84604
Utah County (801) 429-8000

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 Selene Ingraham's NPI number?

The NPI number for Selene Ingraham is 1780577189. It was assigned to this individual provider in the NPPES registry on June 3, 2025.

Where is Selene Ingraham located?

Selene Ingraham practices at 1055 N 500 W Ste 201 Bldg C, Provo, UT 84604. The listed phone number is (801) 429-8000.

What is Selene Ingraham's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Is Selene Ingraham enrolled in Medicare?

Yes. Selene Ingraham 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 Selene Ingraham's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Selene Ingraham reassigns Medicare benefits to 3 organizations: Revere Health PC (Provo, UT), Wasatch Healthcare Group PLLC (Lehi, UT) and Ma Bo Inc (Salt Lake City, UT). 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 Selene Ingraham's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Selene Ingraham accept?

Health plans from BridgeSpan Health Company, Molina Healthcare and Regence BlueCross BlueShield of Utah list Selene Ingraham 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 Selene Ingraham was last updated on June 20, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 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.