Active NPI 1639490386 Individual Practitioner Male Practitioner

Dr. Kevin Hall Gardner , DO

Dermatology • Provo, UT

✓ Accepts Medicare Assignment

Professional Overview & Biography Verified Profile Summary

Dr. Kevin Gardner, DO is a certified Dermatology practicing in Provo, UT. With approximately 16 years of clinical experience since completing medical education in 2010, Dr. Gardner delivers high-quality medical care to the local community at 1055 N 500 W.

Dr. Gardner is affiliated with Ihc Health Services Inc and accepts Medicare assignment.

Frequently performed procedures and clinical services include destruction of precancer skin growth, 2-14 growths, established patient outpatient office visit, destruction of skin growth. Full Medicare procedure pricing transparency rates and service volume details are listed on this profile.

Practice Location & Contact Primary Location

Practice Address

1055 N 500 W
Ste 111

Provo, UT 846043305

Telephone 8013748999

Fax 8014298063

Associated Practice Facility / Clinic

🏢 No Roll Up Timpanogos Llc Facility NPI 1831153840

Medicare Profile & Education

Medical School

Other

Graduation Year

2010

Medicare Assignment

✓ Accepts Assignment

Telehealth Flag

In-Person Only

Specialty Benchmarks & Practice Insights

Comparative analytics for Dermatology in Provo, UT

Established Specialist (10-20 Yrs)

Practitioner Clinical Experience

16 Yrs -11.4 yrs vs City Avg

City Avg: 27.4 Yrs

State Avg: 19.7 Yrs

Regional Practice Density

8 Specialists

Practicing in Provo, UT (184 Statewide)

Telehealth Adoption Rate

12.5% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount

68.7% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Gardner (16 Years) 16 Yrs

Provo Specialty Average (27.4 Years) 27.4 Yrs

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2024)

Reporting Year:

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
17003 Destruction of precancer skin growth, 2-14 growths	1,318	236	$16.00	$6.11
99213 Established patient office or other outpatient visit, typically 15 minutes	404	326	$205.00	$85.80
17000 Destruction of skin growth	379	308	$165.00	$46.66
17311 Removal and microscopic exam of growth of head, neck, hands, feet, or genitals, 1-5 tissue blocks	275	218	$1550.00	$508.53
11102 Tangential biopsy of single skin lesion	135	122	$233.00	$80.08
17110 Destruction of up to 14 skin growths	93	84	$258.90	$95.28
17312 Removal and microscopic exam of growth of head, neck, hands, feet, or genitals, each additional stage, 1-5 tissue blocks	89	66	$941.00	$384.77
17004 Destruction of precancer skin growth, 15 or more growths	79	71	$387.00	$156.70
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	65	65	$252.85	$106.06
12032 Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 2.6-7.5 cm	64	60	$616.00	$173.84
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	58	56	$289.00	$121.70
12052 Repair of wound (2.6 to 5.0 centimeters) of face, ears, eyelids, nose, lips, and/or mouth	46	43	$725.00	$151.05
11103 Biopsy of related skin growth, each additional growth	36	29	$116.00	$41.63
17313 Removal and microscopic exam of growth of trunk, arms, or legs, 1-5 tissue blocks	35	25	$1455.00	$485.49
13132 Complicated repair of wound of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, or feet, 2.6-7.5 cm	34	31	$1080.00	$220.36
15260 Relocation of patient skin to nose, ears, eyelids, and/or lips (20 sq centimeters or less)	29	27	$2276.00	$933.05
11602 Removal of cancer skin growth of body, arms, or legs, 1.1-2.0 cm	22	21	$560.00	$114.83
14060 Repair of wound of eyelids, nose, ears, or lips by transferring skin, 10.0 sq cm or less	21	20	$1752.00	$709.62
12042 Intermediate repair of wound of neck, hands, feet, or genitals, 2.6-7.5 cm	19	19	$703.26	$144.98
17262 Destruction of cancer skin growth of trunk, arms, or legs, 1.1-2.0 cm	18	16	$409.00	$121.07
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	17	17	$377.00	$159.17
11603 Removal of cancer skin growth of body, arms, or legs, 2.1-3.0 cm	16	15	$639.00	$122.81
13152 Complicated repair of wound of eyelids, nose, ears, or lip, 2.6-7.5 cm	14	14	$1139.00	$233.22
J3301 Injection, triamcinolone acetonide, not otherwise specified, 10 mg	14	11	$1.50	$0.82
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	14	14	$129.00	$49.84
13121 Repair of wound (2.6 to 7.5 centimeters) of scalp, arms, and/or legs	14	14	$975.00	$199.04
12051 Intermediate repair of wound of face, ears, eyelids, nose, lips, or mouth, 2.5 cm or less	14	14	$652.00	$141.78
69100 Biopsy of ear	12	11	$222.00	$78.17

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
17003 Destruction of precancer skin growth, 2-14 growths	1,663	276	$14.00	$6.24
17000 Destruction of skin growth	461	368	$165.00	$48.45
99213 Established patient office or other outpatient visit, typically 15 minutes	450	337	$142.76	$85.68
17311 Removal and microscopic exam of growth of head, neck, hands, feet, or genitals, 1-5 tissue blocks	308	224	$1311.00	$506.38
11102 Tangential biopsy of single skin lesion	148	139	$192.33	$87.72
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	106	106	$179.00	$106.80
17110 Destruction of up to 14 skin growths	100	93	$226.00	$99.76
17312 Removal and microscopic exam of growth of head, neck, hands, feet, or genitals, each additional stage, 1-5 tissue blocks	98	68	$785.00	$388.46
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	80	79	$204.65	$119.57
17004 Destruction of precancer skin growth, 15 or more growths	66	58	$341.00	$158.62
12052 Repair of wound (2.6 to 5.0 centimeters) of face, ears, eyelids, nose, lips, and/or mouth	58	55	$593.00	$154.07
11103 Biopsy of related skin growth, each additional growth	47	33	$102.74	$47.48
12032 Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 2.6-7.5 cm	47	47	$616.00	$198.91
13132 Complicated repair of wound of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, or feet, 2.6-7.5 cm	36	36	$1071.11	$224.15
14060 Repair of wound of eyelids, nose, ears, or lips by transferring skin, 10.0 sq cm or less	29	29	$1658.00	$717.26
J7308 Aminolevulinic acid hcl for topical administration, 20%, single unit dosage form (354 mg)	28	19	$682.00	$384.98
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	27	27	$254.78	$149.96
15260 Relocation of patient skin to nose, ears, eyelids, and/or lips (20 sq centimeters or less)	26	25	$2147.08	$947.52
17313 Removal and microscopic exam of growth of trunk, arms, or legs, 1-5 tissue blocks	25	23	$1196.00	$565.66
96567 Application of light and light-sensitive drugs to aid destruction of premalignant skin growths, per session	21	19	$260.67	$129.98
11104 Punch biopsy, first skin growth	20	19	$233.75	$115.75
12042 Intermediate repair of wound of neck, hands, feet, or genitals, 2.6-7.5 cm	20	20	$582.00	$139.76
12053 Intermediate repair of wound of face, ears, eyelids, nose, lips, or mouth, 5.1-7.5 cm	17	17	$700.00	$172.87
17262 Destruction of cancer skin growth of trunk, arms, or legs, 1.1-2.0 cm	17	17	$353.00	$112.44
69100 Biopsy of ear	16	16	$205.00	$59.97
11301 Shaving of skin growth of body, arms, or legs, 0.6-1.0 cm	15	14	$243.00	$104.55
11603 Removal of cancer skin growth of body, arms, or legs, 2.1-3.0 cm	14	13	$569.00	$132.35
12051 Intermediate repair of wound of face, ears, eyelids, nose, lips, or mouth, 2.5 cm or less	14	14	$523.00	$153.70
13121 Repair of wound (2.6 to 7.5 centimeters) of scalp, arms, and/or legs	14	12	$863.00	$202.13
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	12	12	$88.00	$53.55

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
17003 Destruction of precancer skin growth, 2-14 growths	1,761	295	$13.70	$6.37
17000 Destruction of skin growth	492	386	$162.50	$47.70
99213 Established patient office or other outpatient visit, typically 15 minutes	490	379	$121.80	$86.39
17311 Removal and microscopic exam of growth of head, neck, hands, feet, or genitals, 1-5 tissue blocks	239	187	$1294.39	$534.91
11102 Tangential biopsy of single skin lesion	174	156	$184.00	$87.72
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	120	120	$177.40	$107.36
17312 Removal and microscopic exam of growth of head, neck, hands, feet, or genitals, each additional stage, 1-5 tissue blocks	109	72	$776.28	$386.90
17110 Destruction of up to 14 skin growths	109	100	$222.47	$102.37
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	94	91	$175.02	$122.20
11103 Biopsy of related skin growth, each additional growth	74	46	$99.00	$48.86
17004 Destruction of precancer skin growth, 15 or more growths	70	58	$335.97	$160.92
12032 Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 2.6-7.5 cm	53	50	$605.81	$197.98
12052 Repair of wound (2.6 to 5.0 centimeters) of face, ears, eyelids, nose, lips, and/or mouth	40	38	$582.85	$151.95
J7308 Aminolevulinic acid hcl for topical administration, 20%, single unit dosage form (354 mg)	37	25	$682.00	$387.67
17313 Removal and microscopic exam of growth of trunk, arms, or legs, 1-5 tissue blocks	36	31	$1180.72	$492.40
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	27	27	$268.15	$161.34
13121 Repair of wound (2.6 to 7.5 centimeters) of scalp, arms, and/or legs	26	23	$846.85	$229.23
96567 Application of light and light-sensitive drugs to aid destruction of premalignant skin growths, per session	26	24	$236.62	$134.63
13132 Complicated repair of wound of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, or feet, 2.6-7.5 cm	26	26	$1023.31	$227.03
12042 Intermediate repair of wound of neck, hands, feet, or genitals, 2.6-7.5 cm	25	24	$573.04	$155.53
15260 Relocation of patient skin to nose, ears, eyelids, and/or lips (20 sq centimeters or less)	24	22	$2041.83	$949.05
14060 Repair of wound of eyelids, nose, ears, or lips by transferring skin, 10.0 sq cm or less	23	23	$1565.35	$715.36
11104 Punch biopsy, first skin growth	20	19	$231.00	$115.43
69100 Biopsy of ear	19	18	$202.37	$60.92
11603 Removal of cancer skin growth of body, arms, or legs, 2.1-3.0 cm	18	17	$553.44	$126.36
11602 Removal of cancer skin growth of body, arms, or legs, 1.1-2.0 cm	16	15	$490.50	$117.11
17262 Destruction of cancer skin growth of trunk, arms, or legs, 1.1-2.0 cm	14	11	$349.36	$115.72
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	13	11	$74.38	$53.79
11301 Shaving of skin growth of body, arms, or legs, 0.6-1.0 cm	12	12	$239.33	$107.68
12051 Intermediate repair of wound of face, ears, eyelids, nose, lips, or mouth, 2.5 cm or less	12	12	$516.75	$159.24

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
17003 Destruction of precancer skin growth, 2-14 growths	1,774	294	$13.00	$6.21
17000 Destruction of skin growth	464	363	$157.00	$47.25
99213 Established patient office or other outpatient visit, typically 15 minutes	445	339	$116.00	$88.23
17311 Removal and microscopic exam of growth of head, neck, hands, feet, or genitals, 1-5 tissue blocks	231	170	$1248.00	$507.38
11102 Tangential biopsy of single skin lesion	176	153	$184.00	$90.70
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	147	147	$173.00	$107.69
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	95	85	$171.00	$125.41
17312 Removal and microscopic exam of growth of head, neck, hands, feet, or genitals, each additional stage, 1-5 tissue blocks	93	70	$747.00	$393.47
11103 Biopsy of related skin growth, each additional growth	74	43	$99.00	$50.61
17110 Destruction of up to 14 skin growths	74	69	$215.00	$102.64
17004 Destruction of precancer skin growth, 15 or more growths	59	50	$325.00	$158.85
12032 Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 2.6-7.5 cm	48	44	$586.00	$205.34
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	41	41	$264.00	$162.55
13132 Complicated repair of wound of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, or feet, 2.6-7.5 cm	38	37	$978.00	$231.48
15260 Relocation of patient skin to nose, ears, eyelids, and/or lips (20 sq centimeters or less)	37	34	$2062.00	$952.29
69100 Biopsy of ear	31	27	$195.00	$67.59
12052 Repair of wound (2.6 to 5.0 centimeters) of face, ears, eyelids, nose, lips, and/or mouth	31	30	$564.00	$152.62
11104 Punch biopsy, first skin growth	29	27	$231.00	$124.46
J7308 Aminolevulinic acid hcl for topical administration, 20%, single unit dosage form (354 mg)	27	18	$682.00	$391.32
17313 Removal and microscopic exam of growth of trunk, arms, or legs, 1-5 tissue blocks	25	20	$1146.00	$487.22
96567 Application of light and light-sensitive drugs to aid destruction of premalignant skin growths, per session	22	18	$226.00	$136.24
12042 Intermediate repair of wound of neck, hands, feet, or genitals, 2.6-7.5 cm	21	20	$554.00	$157.14
13121 Repair of wound (2.6 to 7.5 centimeters) of scalp, arms, and/or legs	19	19	$821.00	$253.61
11301 Shaving of skin growth of body, arms, or legs, 0.6-1.0 cm	19	18	$232.00	$106.95
11603 Removal of cancer skin growth of body, arms, or legs, 2.1-3.0 cm	18	17	$541.00	$128.21
14060 Repair of wound of eyelids, nose, ears, or lips by transferring skin, 10.0 sq cm or less	18	18	$1586.00	$739.71
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	18	14	$69.00	$54.04
17262 Destruction of cancer skin growth of trunk, arms, or legs, 1.1-2.0 cm	15	12	$336.00	$103.02
12051 Intermediate repair of wound of face, ears, eyelids, nose, lips, or mouth, 2.5 cm or less	13	13	$498.00	$157.97

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
17003 Destruction of precancer skin growth, 2-14 growths	1,552	263	$13.00	$5.74
99213 Established patient office or other outpatient visit, typically 15 minutes	404	322	$115.82	$72.27
17000 Destruction of skin growth	395	325	$153.00	$46.39
11102 Tangential biopsy of single skin lesion	162	144	$184.00	$88.07
17311 Removal and microscopic exam of growth of head, neck, hands, feet, or genitals, 1-5 tissue blocks	150	110	$1226.00	$529.97
99202 New patient office or other outpatient visit, typically 20 minutes	88	88	$124.34	$72.96
17110 Destruction of up to 14 skin growths	86	82	$210.00	$101.00
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	75	75	$173.00	$104.86
17312 Removal and microscopic exam of growth of head, neck, hands, feet, or genitals, each additional stage, 1-5 tissue blocks	71	48	$729.00	$385.20
17004 Destruction of precancer skin growth, 15 or more growths	65	57	$317.00	$150.76
11103 Biopsy of related skin growth, each additional growth	49	36	$99.00	$51.34
12032 Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 2.6-7.5 cm	38	37	$572.00	$238.93
J7308 Aminolevulinic acid hcl for topical administration, 20%, single unit dosage form (354 mg)	38	24	$682.00	$389.64
13132 Complicated repair of wound of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, or feet, 2.6-7.5 cm	31	31	$981.00	$232.82
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	26	25	$69.00	$42.19
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	26	23	$171.00	$106.05
96567 Application of light and light-sensitive drugs to aid destruction of premalignant skin growths, per session	25	24	$226.00	$125.00
11104 Punch biopsy, first skin growth	23	22	$231.00	$121.03
13121 Repair of wound (2.6 to 7.5 centimeters) of scalp, arms, and/or legs	20	19	$801.00	$229.92
12042 Intermediate repair of wound of neck, hands, feet, or genitals, 2.6-7.5 cm	20	20	$541.00	$146.09
11301 Shaving of skin growth of body, arms, or legs, 0.6-1.0 cm	19	18	$226.00	$95.80
69100 Biopsy of ear	18	17	$191.00	$68.64
15260 Relocation of patient skin to nose, ears, eyelids, and/or lips (20 sq centimeters or less)	17	17	$1894.00	$978.99
17313 Removal and microscopic exam of growth of trunk, arms, or legs, 1-5 tissue blocks	15	13	$1146.00	$560.63
11602 Removal of cancer skin growth of body, arms, or legs, 1.1-2.0 cm	13	12	$465.00	$120.08
11603 Removal of cancer skin growth of body, arms, or legs, 2.1-3.0 cm	13	13	$528.00	$137.33
13152 Complicated repair of wound of eyelids, nose, ears, or lip, 2.6-7.5 cm	12	11	$948.00	$246.22
13131 Complicated repair of wound of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, or feet, 1.1-2.5 cm	11	11	$722.00	$206.63

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
17003 Destruction of precancer skin growth, 2-14 growths	2,004	310	$18.00	$5.43
17000 Destruction of skin growth	477	373	$149.00	$44.50
99213 Established patient office or other outpatient visit, typically 15 minutes	418	313	$116.00	$72.00
11102 Tangential biopsy of single skin lesion	237	205	$142.63	$82.43
17311 Removal and microscopic exam of growth of head, neck, hands, feet, or genitals, 1-5 tissue blocks	195	136	$1226.00	$507.22
11103 Biopsy of related skin growth, each additional growth	126	81	$74.17	$50.91
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	117	117	$173.00	$106.71
99202 New patient office or other outpatient visit, typically 20 minutes	116	116	$119.00	$74.88
17110 Destruction of up to 14 skin growths	105	94	$205.00	$96.35
17312 Removal and microscopic exam of growth of head, neck, hands, feet, or genitals, each additional stage, 1-5 tissue blocks	83	62	$721.00	$385.20
J7308 Aminolevulinic acid hcl for topical administration, 20%, single unit dosage form (354 mg)	57	36	$634.35	$391.76
13132 Complicated repair of wound of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, or feet, 2.6-7.5 cm	51	48	$947.00	$234.25
17004 Destruction of precancer skin growth, 15 or more growths	51	47	$309.00	$143.20
12032 Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 2.6-7.5 cm	41	41	$562.00	$236.62
96567 Application of light and light-sensitive drugs to aid destruction of premalignant skin growths, per session	41	36	$226.00	$114.03
69100 Biopsy of ear	34	30	$187.00	$84.86
13121 Repair of wound (2.6 to 7.5 centimeters) of scalp, arms, and/or legs	33	29	$792.00	$231.63
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	30	25	$69.00	$43.98
17262 Destruction of cancer skin growth of trunk, arms, or legs, 1.1-2.0 cm	29	14	$324.00	$108.68
11104 Punch biopsy, first skin growth	26	26	$180.69	$110.75
17313 Removal and microscopic exam of growth of trunk, arms, or legs, 1-5 tissue blocks	24	19	$1146.00	$556.80
11301 Shaving of skin growth of body, arms, or legs, 0.6-1.0 cm	23	19	$222.00	$106.71
15260 Relocation of patient skin to nose, ears, eyelids, and/or lips (20 sq centimeters or less)	22	22	$2125.00	$962.83
11602 Removal of cancer skin growth of body, arms, or legs, 1.1-2.0 cm	21	20	$460.00	$117.84
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	18	16	$171.00	$86.23
11603 Removal of cancer skin growth of body, arms, or legs, 2.1-3.0 cm	17	17	$526.00	$140.18
14060 Repair of wound of eyelids, nose, ears, or lips by transferring skin, 10.0 sq cm or less	16	16	$1634.00	$725.13
13131 Complicated repair of wound of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, or feet, 1.1-2.5 cm	15	14	$715.00	$192.28
12042 Intermediate repair of wound of neck, hands, feet, or genitals, 2.6-7.5 cm	15	15	$536.00	$138.67
12051 Intermediate repair of wound of face, ears, eyelids, nose, lips, or mouth, 2.5 cm or less	14	13	$479.00	$177.13

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
17003 Destruction of precancer skin growth, 2-14 growths	1,494	232	$18.00	$5.08
99213 Established patient office or other outpatient visit, typically 15 minutes	415	312	$115.00	$70.47
17000 Destruction of skin growth	348	282	$146.00	$45.76
11100 Biopsy of single growth of skin and/or tissue	223	196	$190.00	$90.11
17311 Removal and microscopic exam of growth of head, neck, hands, feet, or genitals, 1-5 tissue blocks	201	138	$1210.00	$487.80
11101 Biopsy of each additional growth of skin and/or tissue	118	74	$62.00	$31.97
17312 Removal and microscopic exam of growth of head, neck, hands, feet, or genitals, each additional stage, 1-5 tissue blocks	103	62	$721.00	$376.17
17110 Destruction of up to 14 skin growths	73	62	$200.00	$98.43
99202 New patient office or other outpatient visit, typically 20 minutes	71	71	$118.00	$72.75
J7308 Aminolevulinic acid hcl for topical administration, 20%, single unit dosage form (354 mg)	67	39	$456.97	$398.15
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	66	66	$173.00	$102.74
13132 Complicated repair of wound of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, or feet, 2.6-7.5 cm	56	51	$919.00	$235.97
96567 Application of light and light-sensitive drugs to aid destruction of premalignant skin growths, per session	46	41	$226.00	$106.60
17004 Destruction of precancer skin growth, 15 or more growths	43	37	$302.00	$140.28
69100 Biopsy of ear	28	26	$183.00	$74.78
17262 Destruction of cancer skin growth of trunk, arms, or legs, 1.1-2.0 cm	27	22	$316.00	$135.67
15260 Relocation of patient skin to nose, ears, eyelids, and/or lips (20 sq centimeters or less)	27	23	$2125.00	$992.39
12032 Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 2.6-7.5 cm	25	23	$549.00	$232.62
11301 Shaving of skin growth of body, arms, or legs, 0.6-1.0 cm	21	19	$220.00	$99.29
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	18	18	$69.00	$42.37
12042 Intermediate repair of wound of neck, hands, feet, or genitals, 2.6-7.5 cm	15	15	$523.00	$140.67
11603 Removal of cancer skin growth of body, arms, or legs, 2.1-3.0 cm	14	14	$513.00	$132.60
13121 Repair of wound (2.6 to 7.5 centimeters) of scalp, arms, and/or legs	14	14	$771.00	$236.83
14060 Repair of wound of eyelids, nose, ears, or lips by transferring skin, 10.0 sq cm or less	13	13	$1634.00	$732.11
11602 Removal of cancer skin growth of body, arms, or legs, 1.1-2.0 cm	11	11	$448.00	$120.64
12052 Repair of wound (2.6 to 5.0 centimeters) of face, ears, eyelids, nose, lips, and/or mouth	11	11	$532.00	$143.19
11200 Removal of skin tag, 1-15 skin tags	11	11	$160.00	$59.24

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
17003 Destruction of precancer skin growth, 2-14 growths	1,010	170	$18.00	$5.40
17000 Destruction of skin growth	257	217	$142.00	$43.82
99213 Established patient office or other outpatient visit, typically 15 minutes	228	173	$115.25	$69.93
11100 Biopsy of single growth of skin and/or tissue	194	164	$188.00	$86.14
17311 Removal and microscopic exam of growth of head, neck, hands, feet, or genitals, 1-5 tissue blocks	162	110	$1210.00	$500.42
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	115	115	$173.00	$104.18
11101 Biopsy of each additional growth of skin and/or tissue	98	51	$62.00	$31.99
99202 New patient office or other outpatient visit, typically 20 minutes	82	82	$118.00	$72.17
17110 Destruction of up to 14 skin growths	56	52	$200.00	$99.74
17312 Removal and microscopic exam of growth of head, neck, hands, feet, or genitals, each additional stage, 1-5 tissue blocks	55	39	$721.00	$369.32
13132 Complicated repair of wound of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, or feet, 2.6-7.5 cm	41	37	$864.00	$241.69
17004 Destruction of precancer skin growth, 15 or more growths	33	31	$294.00	$144.67
69100 Biopsy of ear	32	27	$183.00	$75.42
17313 Removal and microscopic exam of growth of trunk, arms, or legs, 1-5 tissue blocks	27	18	$1117.00	$485.19
15260 Relocation of patient skin to nose, ears, eyelids, and/or lips (20 sq centimeters or less)	25	24	$2125.00	$988.49
12032 Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 2.6-7.5 cm	24	21	$549.00	$188.24
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	24	23	$69.00	$41.82
88305 Pathology examination of tissue using a microscope, intermediate complexity	21	13	$191.81	$64.32
13121 Repair of wound (2.6 to 7.5 centimeters) of scalp, arms, and/or legs	19	18	$771.00	$204.75
12042 Intermediate repair of wound of neck, hands, feet, or genitals, 2.6-7.5 cm	15	15	$523.00	$154.11
12052 Repair of wound (2.6 to 5.0 centimeters) of face, ears, eyelids, nose, lips, and/or mouth	14	14	$532.00	$152.16
11301 Shaving of skin growth of body, arms, or legs, 0.6-1.0 cm	13	12	$217.00	$110.70
14060 Repair of wound of eyelids, nose, ears, or lips by transferring skin, 10.0 sq cm or less	12	12	$1634.00	$759.33
13152 Complicated repair of wound of eyelids, nose, ears, or lip, 2.6-7.5 cm	11	11	$918.00	$253.78

Medical Specialties & State Licenses

CMS Verified: 2021-09-08

Dermatology Primary Specialty

NUCC Taxonomy Code: 207N00000X

State License UT 9332631-1204

A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging.

Student in an Organized Health Care Education/Training Program

NUCC Taxonomy Code: 390200000X

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

Dermatology

NUCC Taxonomy Code: 207N00000X

State License MN 54109

Dermatology - MOHS-Micrographic Surgery

NUCC Taxonomy Code: 207ND0101X

State License UT 9332631-1204

The highly-trained surgeons that perform Mohs Micrographic Surgery are specialists both in dermatology and pathology. With their extensive knowledge of the skin and unique pathological skills, they are able to remove only diseased tissue, preserving healthy tissue and minimizing the cosmetic impact of the surgery. Mohs surgeons who belong to the American College of Mohs Surgery (ACMS) have completed a minimum of one year of fellowship training at one of the ACMS-approved training centers in the U.S.

Hospital & Practice Group Affiliations

Ihc Health Services Inc

700 S Hwy 99, Fillmore, UT 846315137

Phone: 8013574600

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

7 Associated Practitioners

Jaddon Rogers , PA-C

Physician Assistant

NPI 1134638810

Physician Assistant (Certified)

Dr. Payam Tristani-Firouzi , MD

Dermatology

NPI 1407943921

Doctor of Medicine (M.D.)

Dr. Jake Fagan , MD

Dermatology - MOHS-Micrographic Surgery

NPI 1548688989

Doctor of Medicine (M.D.)

Dr. Reed Garza , MD

Dermatology

NPI 1669715819

Doctor of Medicine (M.D.)

Nicole Rawle , APRN

Nurse Practitioner

NPI 1669777314

Advanced Practice Registered Nurse

Dr. Brian Bradshaw , MD

Dermatology

NPI 1811955800

Doctor of Medicine (M.D.)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) September 08, 2021

Student in an Organized Health Care Education/Training Program

✅

NPI Profile Active May 15, 2015

NPI status registered as active in NPPES database

📍

Updated Practice Location May 15, 2015

Registered at 1055 N 500 W, STE 111, PROVO, UT 846043305 (Tel: 8013748999)

📍

Updated Business Mailing Address May 15, 2015

Registered at 1055 N 500 W, ATTN: CREDENTIALING, PROVO, UT 846043305 (Tel: 8013748999)

👤

Provider Name / Credentials Updated May 15, 2015

Recorded as KEVIN GARDNER, DO

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) May 15, 2015

Dermatology (License #9332631-1204 in UT)

🟢

Initial NPI Registration & Enumeration June 17, 2010

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1639490386

Entity Type:

Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)

Enumeration Date: June 17, 2010

Last Update: September 08, 2021

Sole Proprietor: No

Update or Correct Profile

Mailing Address

1055 N 500 W, Attn: Credentialing

Provo, UT 846043305

Phone: 8013748999

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).

⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.