KELLEY MIKKELSON – Family Nurse Practitioner, NPI 1609437714
Family Nurse Practitioner
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
5,720 NURSE PRACTITIONER in MN
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Provider Addresses for KELLEY MIKKELSON
Lake Victoria, Alexandria, Douglas County, Minnesota, United States
ALEXANDRIA, MN 563085508
Phone: (320) 760-7301
Type: Mailing
24, 7th Street, Dunlap, Morris County, Kansas, 66846, United States
MORRIS, MN 562671312
Phone: (320) 589-4008
Type: Location
610 30TH AVE W
ALEXANDRIA, MN 563083426
Phone: (320) 763-2540
Type: Mailing
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 $13.
Total Amount is formed as General ($13) + Research ($0) + Ownership ($0) = $13.
Last reported payment date: 2023-02-09 • Largest payer in this snapshot: Merck Sharp & Dohme LLC ($13).
Total Amount
$13
General + Research + Ownership
Payments
1
Total payment records
General Amount
$13
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2023-02-09
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Merck Sharp & Dohme LLC | $13 |
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: 2019-10-22
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
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 |
|---|---|---|---|---|
| I20191022002588 | I | Nurse Practitioner | MN | 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 |
|---|---|---|---|---|
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 151 | 117 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 56 | 49 | $0 |
| 99215 | Established patient office or other outpatient visit, 40-54 minutes | 55 | 45 | $0 |
Insurance plans in this area (ZIP 56308)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Certified Registered Nurse Anesthetist (Crna) | MN | |
| Internal Medicine | MN | |
| O B S T E T R I C S/ G Y N E C O L O G Y | MN | |
| H O S P I T A L I S T | MN | |
| Emergency Medicine | MI | |
| Emergency Medicine | MN | |
| Emergency Medicine | MN | |
| U R O L O G Y | MN | |
| Physician Assistant | MN | |
| Emergency Medicine | MN |
Reviews
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