KELLY D MIKESELL (PA-C) – Medical Physician Assistant, NPI 1023200888
Medical Physician Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
1,971 PHYSICIAN ASSISTANT in UT
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Provider Addresses for KELLY D MIKESELL (PA-C)
Revere Health, 1055, North 500 West, North Park, Provo, Utah County, Utah, 84604, United States
ATTN: CREDENTIALING
PROVO, UT 84604
Phone: (801) 354-8225
Fax: (801) 418-0941
Type: Mailing
9000 South, West Jordan, Salt Lake County, Utah, 84070, United States
WEST JORDAN, UT 840888875
Phone: (801) 566-9211
Fax: (801) 566-5667
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 393 Open Payments records for all available years, with a total value of $9,041.
Total Amount is formed as General ($9,041) + Research ($0) + Ownership ($0) = $9,041.
Last reported payment date: 2024-12-23 • Largest payer in this snapshot: Novartis Pharmaceuticals Corporation ($668).
Total Amount
$9,041
General + Research + Ownership
Payments
393
Total payment records
General Amount
$9,041
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-23
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Novartis Pharmaceuticals Corporation | $668 |
| Astellas Pharma US Inc | $598 |
| Incyte Corporation | $562 |
| Janssen Biotech, Inc. | $531 |
| ABBVIE INC. | $364 |
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: 2007-09-13
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 |
|---|---|---|---|---|
| I20070913000374 | I | Physician Assistant | 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 |
|---|---|---|---|---|
| Q5125 | Injection, filgrastim-ayow, biosimilar, (releuko), 1 microgram | 16,320 | 11 | $0 |
| Q0138 | Injection, ferumoxytol, for treatment of iron deficiency anemia, 1 mg (non-esrd use) | 15,300 | 15 | $0 |
| J1449 | Injection, eflapegrastim-xnst, 0.1 mg | 4,620 | 12 | $0 |
| J1437 | Injection, ferric derisomaltose, 10 mg | 3,200 | 22 | $0 |
| J0897 | Injection, denosumab, 1 mg | 2,940 | 19 | $0 |
Insurance plans in this area (ZIP 84604)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Physician Assistant | UT | |
| P O D I A T R Y | CO | |
| D E R M A T O L O G Y | CO | |
| Physician Assistant | UT | |
| Nurse Practitioner | UT | |
| Qualified Speech Language Pathologist | CO | |
| N E U R O L O G Y | CO | |
| Family Practice, Sports Medicine | CO | |
| Neurology, Sleep Medicine | CO | |
| Nurse Practitioner | UT |
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