MINDY BACCAM SOUTHAMMAVONG PA-C
NPI 1528434859
Physician Assistant - Medical in Pella, IA
About Mindy Baccam Southammavong Pa-c NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MINDY BACCAM SOUTHAMMAVONG PA-C (NPI 1528434859) is an individual medical provider in Pella, Iowa, licensed in Iowa (078982) and active in the NPI registry since August 2015. She is enrolled in Medicare PECOS, is affiliated with Pella Regional Health Center, and is a graduate of Other (2015).
NPPES Registry Identity
Specialties & Licenses
Other Names 1
Other Identifiers 3
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
Mindy Baccam Southammavong 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.
Hospital Affiliations CMS Care Compare
Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.
Pella Regional Health Center
Critical Access Hospitals · Pella, IAMedicare 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 20
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
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 Mindy Southammavong's NPI number?
The NPI number for Mindy Southammavong is 1528434859. It was assigned to this individual provider in the NPPES registry on August 20, 2015. The provider is also known as Mindy Shine Baccam.
Where is Mindy Southammavong located?
Mindy Southammavong practices at 405 Monroe St, Pella, IA 50219. The listed phone number is (641) 621-2200.
What is Mindy Southammavong's specialty?
The primary specialty registered for this NPI is Physician Assistant, specializing in Medical, with taxonomy code 363AM0700X.
Is Mindy Southammavong enrolled in Medicare?
Yes. Mindy Southammavong 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 Mindy Southammavong accept?
Health plans from Ambetter Health, Ambetter Health of Delaware, Ambetter from Home State Health, Ambetter from NH Healthy Families and Ambetter from Sunflower Health Plan and 2 other insurers list Mindy Southammavong 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 Mindy Southammavong affiliated with any hospitals?
According to CMS data, Mindy Southammavong is affiliated with Pella Regional Health Center.
When was this NPI record last updated?
The NPPES record for Mindy Southammavong was last updated on May 1, 2017. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 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.
# Mindy Baccam Southammavong, PA-C · NPI 1528434859
Medical physician in Pella, Iowa. Individual provider, active in the CMS NPPES registry since August 20, 2015.
## Identity
- **NPI:** 1528434859 (Entity type: Individual)
- **Enumerated:** August 20, 2015
- **Primary specialty:** Physician Assistant - Medical · taxonomy 363AM0700X
- **State license:** 078982 (Iowa)
- **Sole proprietor:** No
## Practice location
- **Address:** 405 MONROE ST, Pella, IA 50219-1189
- **Phone:** (641) 621-2200 · **Fax:** (641) 621-2335
## 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 2015
## Record status
- **NPPES last updated:** May 1, 2017
- **Other identifiers:** Other 1528434859 (IA); Other 078982 (IA); Medicare PIN 560910077 (IA)
---
Source: [NPI Profile](https://npiprofile.com/npi/1528434859) · Data from the CMS NPPES public registry.