Kelsey Elizabeth Bodell, P.A.

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

50.009589RX Issued in OH

Practice address

6150 Park Square Dr
Ste B
Lorain, OH 44053-4153

Phone

(440) 984-6499

Fax

(234) 757-7545

NPI assigned

Sep 3, 2019

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in TX, OH2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Specialty

Physician Assistant

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Oliver Street 5.01(a) IncGroup PAC ID 0042464125, 169 clinicians

Apex Dermatology and Skin Surgery Center, LLCGroup PAC ID 1052589777, 52 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kwheeler@dermatologyassociates.emadirect.md
• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Apex Dermatology and Skin Surgery Center, LLC

  • Dermatology Physician
  • Mayfield Heights, OH
  • NPI 1689973638
  Medicare reassignment Care Compare group NPD
• Oliver Street 5.01(a) Inc.

  • Dermatology Physician
  • Dallas, TX
  • NPI 1457695413
  Medicare reassignment Care Compare group
• Gary R Kutsikovich MD and Associates Inc

  • Neurology Physician
  • Mentor, OH
  • NPI 1841250420
  NPD (past)
• SCH Professional Corporation

  • Family Medicine Physician
  • Salem, OH
  • NPI 1619959822
  NPD (past)
• Dermatology Associates

  • Dermatology Physician
  • Houston, TX
  • NPI 1356523039
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1567468800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761696000000",
    "number": "1215585237",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2000 AUBURN DR STE 350",
            "city": "BEACHWOOD",
            "state": "OH",
            "postal_code": "441224327",
            "telephone_number": "440-646-1600",
            "fax_number": "440-646-1505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6150 PARK SQUARE DR",
            "address_2": "STE B",
            "city": "LORAIN",
            "state": "OH",
            "postal_code": "440534153",
            "telephone_number": "440-984-6499",
            "fax_number": "234-757-7545"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BODELL",
        "first_name": "KELSEY",
        "middle_name": "ELIZABETH",
        "name_prefix": "Mrs.",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-03",
        "last_updated": "2025-10-29",
        "certification_date": "2025-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA13347",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OH",
            "license": "50.009589RX",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Akil Blanton
• Blissful Living Home Care
• Julius Boakye, M.D.
• Kelli Ann Boda
• Venkat Boddapati, MD
• Michelle Rae Boden, LMT
• Ava Boesel, CDCA
• Nathan A Boggs, CDCA
• Laurie Bohaty
• Ilma Bokman

• Physician Assistant in Lorain, OH
• Providers in Lorain, OH by specialty
• Physician Assistant in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.