CODY BRAD MICKELSEN (MD) – Anesthesiology Physician, NPI 1013159003
Anesthesiology Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
5,262 ANESTHESIOLOGY in NY
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Provider Addresses for CODY BRAD MICKELSEN (MD)
274, Main Street, Sterling, Logan County, Colorado, 80751, United States
BOX 604
LOGAN, UT 843213915
Phone: (435) 753-1600
Type: Mailing
University of Rochester Medical Center, 601, Elmwood Avenue, Upper Mount Hope, Rochester, Monroe, New York, 14611, United States
BOX 604
ROCHESTER, NY 146420001
Phone: (585) 275-1384
Fax: (585) 276-0122
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 $16.
Total Amount is formed as General ($16) + Research ($0) + Ownership ($0) = $16.
Last reported payment date: 2024-04-25 • Largest payer in this snapshot: Pacira Pharmaceuticals Incorporated ($16).
Total Amount
$16
General + Research + Ownership
Payments
1
Total payment records
General Amount
$16
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-04-25
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Pacira Pharmaceuticals Incorporated | $16 |
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: 2016-07-27
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 |
|---|---|---|---|---|
| I20160727002395 | I | Anesthesiology | UT | 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 |
|---|---|---|---|---|
| 00811 | Anesthesia for other procedure on large bowel using an endoscope | 11 | 11 | $0 |
Insurance plans in this area (ZIP 84321)
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Provider's Procedures
Group practice members
| Name | Specialty | State |
|---|---|---|
| A N E S T H E S I O L O G Y | UT | |
| - | UT | |
| Anesthesiology, Pain Management | PA | |
| A N E S T H E S I O L O G Y | UT | |
| - | UT | |
| A N E S T H E S I O L O G Y | AZ | |
| A N E S T H E S I O L O G Y | AZ | |
| A N E S T H E S I O L O G Y | UT | |
| Certified Registered Nurse Anesthetist (Crna) | WA | |
| A N E S T H E S I O L O G Y | OR |
Reviews
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