KELSEY GLEASON (PA-C) – Surgical Physician Assistant, NPI 1205217890
Surgical Physician Assistant
Main info
Doctor Profile
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Profile Insights
NPPES metrics only — not quality of care.
1,971 PHYSICIAN ASSISTANT in UT
Provider Addresses for KELSEY GLEASON (PA-C)
700 W 800 N Ste 100
Orem, UT 840576301
Phone: (801) 373-7350
Fax: (801) 224-5337
Type: Location
1055 N 500 W Ste 121
Provo, UT 84604
Phone: (801) 373-7350
Fax: (801) 812-5401
Type: Location
1055 N 500 W
ATT: CREDENTIALING
PROVO, UT 846043305
Phone: (801) 354-8225
Fax: (801) 418-0941
Type: Mailing
1055 N 500 W STE 121
PROVO, UT 84604
Phone: (801) 373-7350
Fax: (801) 812-5401
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 $136.
Total Amount is formed as General ($136) + Research ($0) + Ownership ($0) = $136.
Last reported payment date: 2023-03-30 • Largest payer in this snapshot: Neurocrine BioSciences, Inc. ($136).
Total Amount
$136
General + Research + Ownership
Payments
1
Total payment records
General Amount
$136
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2023-03-30
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Neurocrine BioSciences, Inc. | $136 |
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: 2023-04-25
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 |
|---|---|---|---|---|
| I20230425001000 | I | Physician Assistant | IL | 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.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 84057)
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Provider's Procedures
Group practice members
| Name | Specialty | State |
|---|---|---|
| Physician Assistant | IL | |
| O B S T E T R I C S/ G Y N E C O L O G Y | IL | |
| Internal Medicine | IL | |
| Family Practice, General Surgery, Preventive Medicine | IL | |
| - | IL | |
| - | MI | |
| Internal Medicine | ME | |
| General Surgery, Vascular Surgery | KY | |
| Family Practice | IL | |
| Physician Assistant | OH |
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