SOUTSADA NIKKI KONESAVANH PA-C
NPI 1417108606
Physician Assistant - Medical in Salt Lake City, UT
About Soutsada Nikki Konesavanh Pa-c NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
SOUTSADA NIKKI KONESAVANH PA-C (NPI 1417108606) is an individual medical provider in Salt Lake City, Utah, licensed in Utah (7138480-1206) and active in the NPI registry since October 2008. She is enrolled in Medicare PECOS, is affiliated with University Of Utah Hospitals And Clinics, and is a graduate of Other (2008).
NPPES Registry Identity
Specialties & Licenses 2
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Soutsada Nikki Konesavanh Pa-c is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.
Areas of Expertise CMS Part B claims
Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.
Hospital Affiliations CMS Care Compare
Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.
University Of Utah Hospitals And Clinics
Acute Care Hospitals · Salt Lake City, UTMedicare Quality Performance CMS QPP · MIPS
Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.
Other Providers at the Same Location NPPES 9
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
SALT LAKE CITY, UT 84112
SALT LAKE CITY, UT 84112
SALT LAKE CITY, UT 84112
SALT LAKE CITY, UT 84112
SALT LAKE CITY, UT 84112
SALT LAKE CITY, UT 84112
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Soutsada Konesavanh's NPI number?
The NPI number for Soutsada Konesavanh is 1417108606. It was assigned to this individual provider in the NPPES registry on October 6, 2008.
Where is Soutsada Konesavanh located?
Soutsada Konesavanh practices at 100 Mario Capecchi Dr, Salt Lake City, UT 84112. The listed phone number is (801) 585-2341.
What is Soutsada Konesavanh's specialty?
The primary specialty registered for this NPI is Physician Assistant, specializing in Medical, with taxonomy code 363AM0700X.
Is Soutsada Konesavanh enrolled in Medicare?
Yes. Soutsada Konesavanh is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.
What insurance does Soutsada Konesavanh accept?
Health plans from Select Health list Soutsada Konesavanh as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
Is Soutsada Konesavanh affiliated with any hospitals?
According to CMS data, Soutsada Konesavanh is affiliated with University Of Utah Hospitals And Clinics.
When was this NPI record last updated?
The NPPES record for Soutsada Konesavanh was last updated on November 17, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Soutsada Nikki Konesavanh, PA-C · NPI 1417108606
Medical physician in Salt Lake City, Utah. Individual provider, active in the CMS NPPES registry since October 6, 2008.
## Identity
- **NPI:** 1417108606 (Entity type: Individual)
- **Enumerated:** October 6, 2008
- **Primary specialty:** Physician Assistant - Medical · taxonomy 363AM0700X
- **State license:** 7138480-1206 (Utah)
- **Sole proprietor:** Yes
## Practice location
- **Address:** 100 MARIO CAPECCHI DR, Salt Lake City, UT 84112-8924
- **Phone:** (801) 585-2341
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Medical school:** Other, class of 2008
## Record status
- **NPPES last updated:** November 17, 2021
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Source: [NPI Profile](https://npiprofile.com/npi/1417108606) · Data from the CMS NPPES public registry.