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MRS. KELSEY DENISE MENEGOTTO DMD
NPI 1932525136
Dentist - Oral and Maxillofacial Surgery in Indianapolis, IN

Active since March 12, 2014Opted out of Medicare · through Oct 2, 2026
777 BEACHWAY DR STE 202, INDIANAPOLIS, IN 46224(317) 297-1007(317) 405-8694 Get Directions Write a Review

NPPES record last updated: June 22, 2021. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jun 22, 2021, Apr 18, 2018, Apr 13, 2018 (3 updates tracked since 2018).

About Mrs. Kelsey Denise Menegotto Dmd NPPES

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

MRS. KELSEY DENISE MENEGOTTO DMD (NPI 1932525136) is an individual oral and maxillofacial surgery provider in Indianapolis, Indiana, licensed in Indiana (12013532A) and active in the NPI registry since March 2014. She has opted out of Medicare through October 2, 2026 and remains eligible to order and refer and maintains a secondary practice location in Brownsburg.

NPPES Registry Identity

NPI1932525136
Entity TypeIndividualFemale
Primary Taxonomy1223S0112X
Provider Legal NameMRS. KELSEY DENISE MENEGOTTOCredential: DMD
Location Address777 BEACHWAY DR STE 202Indianapolis, IN 46224-7877
Mailing Address10972 Allisonville Rd Ste 110Fishers, IN 46038-2639 · (270) 314-6363 · Fax (317) 913-2360
Phone(317) 297-1007
Fax(317) 405-8694
Sole ProprietorYes
Enumeration DateMarch 12, 2014
Last NPPES UpdateJune 22, 20213 updates tracked since enumeration
NPPES CertifiedJune 22, 2021
✔ NPI 1932525136 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyDentist · Oral and Maxillofacial SurgeryDental Providers
Taxonomy Code1223S0112X
License✔ Licensed in IN · 12013532A
Definition
An oral and maxillofacial surgery dentist specialized in the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region.
Also ListedDentistTaxonomy 122300000X · License 9892 (KY)
Also ListedOral & Maxillofacial SurgeryTaxonomy 204E00000X · License 9892 (KY)
777 BEACHWAY DR STE 202, Indianapolis, IN 46224
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Other Names 1

Former Name (1)Mrs. Kelsey Denise Johnson

Secondary Practice Location 1

Location 11040 Patrick Pl Ste ABrownsburg, IN 46112-2432 · Phone (317) 297-1007 · Fax (317) 405-8694

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, BEST Life, Blue Cross and Blue Shield of Alabama and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Mrs. Kelsey Denise Menegotto Dmd has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from October 2, 2024 through October 2, 2026.

Opt-Out Effective DateOctober 2, 2024
Opt-Out In Effect ThroughOctober 2, 2026Opt-out affidavits renew automatically every two years unless cancelled
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesAn opted-out provider can still order and refer for Medicare patients in the categories marked above, even though their own services are not covered.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 46224 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
$82.04 typical visit price
range $53.07 – $161.76
Typical copayment $20.51 (range $13.26 – $40.44)
Most-billed visit code 99203
Established Patient
$66.48 typical visit price
range $16.93 – $132.22
Typical copayment $16.62 (range $4.23 – $33.05)
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.

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 Kelsey Menegotto's NPI number?

The NPI number for Kelsey Menegotto is 1932525136. It was assigned to this individual provider in the NPPES registry on March 12, 2014. The provider is also known as Mrs. Kelsey Denise Johnson.

Where is Kelsey Menegotto located?

Kelsey Menegotto practices at 777 Beachway Dr Ste 202, Indianapolis, IN 46224. The listed phone number is (317) 297-1007.

What is Kelsey Menegotto's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Oral and Maxillofacial Surgery, with taxonomy code 1223S0112X.

Is Kelsey Menegotto enrolled in Medicare?

No. Kelsey Menegotto has opted out of Medicare through October 2, 2026. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out. The provider remains eligible to order and refer services for Medicare patients.

What insurance does Kelsey Menegotto accept?

Health plans from Anthem Blue Cross and Blue Shield, BEST Life, Blue Cross and Blue Shield of Alabama, Blue Cross and Blue Shield of Montana and Blue Cross and Blue Shield of Oklahoma and 5 other insurers list Kelsey Menegotto 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 Kelsey Menegotto was last updated on June 22, 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.