KELLEN TAGE HANSEN (D.O.) – Sports Medicine (Family Medicine) Physician, NPI 1396007316
Sports Medicine (Family Medicine) Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
2,861 FAMILY PRACTICE in IN
Provider Addresses for KELLEN TAGE HANSEN (D.O.)
205 N Tillotson Ave
Muncie, IN 473043900
Phone: (765) 288-1928
Fax: (765) 741-0335
Type: Location
12473 S Minuteman Dr
Draper, UT 840207870
Phone: (801) 495-7970
Fax: (801) 495-7990
Type: Location
3943 E Pony Express Pkwy Ste 210
Eagle Mountain, UT 840055544
Phone: (801) 789-3030
Fax: (801) 789-3039
Type: Location
3401 N CENTER ST STE 100
LEHI, UT 84043
Phone: (801) 753-7770
Fax: (801) 753-7775
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 1 Open Payments records for all available years, with a total value of $15.
Total Amount is formed as General ($15) + Research ($0) + Ownership ($0) = $15.
Last reported payment date: 2023-03-04 • Largest payer in this snapshot: Boston Scientific Corporation ($15).
Total Amount
$15
General + Research + Ownership
Payments
1
Total payment records
General Amount
$15
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2023-03-04
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Boston Scientific Corporation | $15 |
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2025-07-29
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 2 Medicare enrollment records; no due dates published yet.
Enrollment records
2
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20170630001472 | I | Family Practice | UT | TBD |
| I20250729003500 | I | Family Practice | ID | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| J3301 | Injection, triamcinolone acetonide, not otherwise specified, 10 mg | 173 | 25 | $0 |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 57 | 28 | $0 |
| 20610 | Aspiration and/or injection of fluid from large joint | 35 | 16 | $0 |
| 99204 | New patient office or other outpatient visit, 45-59 minutes | 14 | 14 | $0 |
| 73564 | X-ray of knee, 4 or more views | 13 | 11 | $0 |
Insurance plans in this area (ZIP 47304)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Sports Medicine | UT | |
| Sports Medicine | UT | |
| Physical Medicine And Rehabilitation | TX | |
| Orthopedic Surgery, Sports Medicine | MS | |
| Sports Medicine, Family Practice | UT | |
| Family Practice, Sports Medicine | WY |
Reviews
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