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LISA MARIE GRAVELLE M.D.
NPI 1821028820
Obstetrics & Gynecology in Salt Lake City, UT

Active since July 04, 2006PECOS EnrolledAccepts Medicare Assignment
5063 S COTTONWOOD ST, SALT LAKE CITY, UT 84107(801) 507-1800(801) 507-1825 Get Directions Write a Review

NPPES record last updated: September 24, 2025. Verified against the NPPES registry weekly; last sync: November 01, 2026.

About Lisa Marie Gravelle M.d. NPPES

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

LISA MARIE GRAVELLE M.D. (NPI 1821028820) is an individual obstetrics & gynecology provider in Salt Lake City, Utah, licensed in Utah (5640031-1205) and active in the NPI registry since July 2006. She is enrolled in Medicare PECOS and is a graduate of University Of Washington School Of Medicine (2000).

NPPES Registry Identity

NPI1821028820
Entity TypeIndividualFemale
Primary Taxonomy207V00000X
Provider Legal NameLISA MARIE GRAVELLECredential: M.D.
Location Address5063 S COTTONWOOD STSalt Lake City, UT 84107-6766
Mailing AddressPo Box 27128Salt Lake City, UT 84127-0128
Phone(801) 507-1800
Fax(801) 507-1825
Sole ProprietorNo
Medical School CMSUniversity Of Washington School Of MedicineGraduated 2000
Enumeration DateJuly 4, 2006
Last NPPES UpdateSeptember 24, 2025
NPPES CertifiedSeptember 24, 2025
✔ NPI 1821028820 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyObstetrics & GynecologyAllopathic & Osteopathic Physicians
Taxonomy Code207V00000X
License✔ Licensed in UT · 5640031-1205
Definition
An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women.
5063 S COTTONWOOD ST, Salt Lake City, UT 84107
Open in Google Maps ↗

Other Names 1

Professional Name (2)Lisa M. Gravelle M.d.

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Select Health.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

Lisa Marie Gravelle M.d. 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 ID4284613142
PECOS Enrollment IDI20040715000548
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 Reassignment

Medicare enrollment records show Lisa Gravelle reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Ihc Health Services Inc
Same address
Obstetrics & Gynecology
5063 COTTONWOOD ST, #120
Murray, UT 84107
  • Reassigned Medicare billing, Utah enrollment
  • 3,691 clinicians in this Medicare group
NPI 1831387539 (801) 507-1800

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 84107 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
$125.70 typical visit price
range $54.34 – $166.03
Typical copayment $31.42 (range $13.58 – $41.50)
Most-billed visit code 99204
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 8

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

IHC HEALTH SERVICES INC
Clinic/Center (Radiology, Mobile Mammography)
5063 S COTTONWOOD ST
MURRAY, UT 84107
Salt Lake County (833) 626-6646
DR. TAYLOR JEFFERY NORTON MD
Obstetrics & Gynecology (Gynecologic Oncology)
5063 S COTTONWOOD ST
MURRAY, UT 84107
Salt Lake County (801) 507-1800
MS. LUZ ELENA RENI DNP
Nurse Practitioner (Primary Care)
5063 S COTTONWOOD ST
MURRAY, UT 84107
Salt Lake County (801) 507-1800
DR. AMELIA PARRETT M.D.
Obstetrics & Gynecology
5063 S COTTONWOOD ST, SUITE 120
SALT LAKE CITY, UT 84107
Salt Lake County (801) 507-1800
REBECCA SUE KLOTZER PA-C
Physician Assistant
5063 S COTTONWOOD ST, STE 120
MURRAY, UT 84107
Salt Lake County (801) 507-1800
VERONICA SO FOX MD
Obstetrics & Gynecology
5063 S COTTONWOOD ST
MURRAY, UT 84107
Salt Lake County (801) 507-1800
HEIDI BEDONT PA-C
Physician Assistant
5063 S COTTONWOOD ST
MURRAY, UT 84107
Salt Lake County (801) 507-1800
DR. MARK CLIFFTON TEMPLEMAN M.D.
Pediatrics
5063 S COTTONWOOD ST, SUITE 160
MURRAY, UT 84107
Salt Lake County (801) 507-1850

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 Lisa Gravelle's NPI number?

The NPI number for Lisa Gravelle is 1821028820. It was assigned to this individual provider in the NPPES registry on July 4, 2006. The provider is also known as Lisa M. Gravelle M.D..

Where is Lisa Gravelle located?

Lisa Gravelle practices at 5063 S Cottonwood St, Salt Lake City, UT 84107. The listed phone number is (801) 507-1800.

What is Lisa Gravelle's specialty?

The primary specialty registered for this NPI is Obstetrics & Gynecology with taxonomy code 207V00000X.

Is Lisa Gravelle enrolled in Medicare?

Yes. Lisa Gravelle 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 organization bills Medicare for Lisa Gravelle's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Lisa Gravelle reassigns Medicare benefits to Ihc Health Services Inc (Murray, UT). The 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 Lisa Gravelle's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Lisa Gravelle accept?

Health plans from Select Health list Lisa Gravelle 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 Lisa Gravelle was last updated on September 24, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 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.