Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Brandon Shawn Mickelson, PA-C

Individual provider Physician Assistant · NPI 1790544534

Brandon Shawn Mickelson, PA-C is a Physician Assistant in Draper, Utah. Qualified in 2024, 2 years ago. Practices with Springville Dermatology and Diagnostics PC, a 6-clinician group and accepts Medicare assignment.

Years since qualifying
2
In the registry since
2024
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

11760 S 700 E Ste 112
Draper, UT 84020-6605
Phone: (801) 882-9995
Fax: (801) 882-9994
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X

Record details

NPI number1790544534
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorNo
NPI enumeratedMarch 14, 2024
Last updated in NPPESMay 9, 2024
Certification dateMay 9, 2024

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2024 (2 years in practice)
Group practice Springville Dermatology And Diagnostics Pc — 6 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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