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Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

MS. GRACE SUYANTI MULIAWAN PA-C
NPI 1649879081
Physician Assistant in Challis, ID

Active since October 17, 2020PECOS EnrolledAccepts Medicare Assignment
611 CLINIC RD, CHALLIS, ID 83226(208) 879-4351(208) 879-5216 Get Directions Write a Review

NPPES record last updated: June 29, 2026. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Aug 25, 2023, Mar 24, 2023, Aug 6, 2022 and 2 more (5 updates tracked since 2020).

About Ms. Grace Suyanti Muliawan Pa-c NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MS. GRACE SUYANTI MULIAWAN PA-C (NPI 1649879081) is an individual physician assistant in Challis, Idaho, licensed in Idaho (PA-1991) and active in the NPI registry since October 2020. She is enrolled in Medicare PECOS, is affiliated with St Luke's Regional Medical Center, and is a graduate of Other (2020).

NPPES Registry Identity

NPI1649879081
Entity TypeIndividualFemale
Primary Taxonomy363A00000X
Provider Legal NameMS. GRACE SUYANTI MULIAWANCredential: PA-C
Location Address611 CLINIC RDChallis, ID 83226-4824
Mailing AddressPo Box 980Challis, ID 83226-0980 · (208) 879-4351 · Fax (208) 879-5216
Phone(208) 879-4351
Fax(208) 879-5216
Sole ProprietorNo
Medical School CMSOtherGraduated 2020
Enumeration DateOctober 17, 2020
Last NPPES UpdateJune 29, 20265 updates tracked since enumeration
NPPES CertifiedJune 29, 2026
✔ NPI 1649879081 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
License✔ Licensed in ID · PA-1991
Definition
A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.
Also ListedPhysician Assistant · MedicalTaxonomy 363AM0700X · License PA-1991 (ID)
611 CLINIC RD, Challis, ID 83226
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Providence Health Plan.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

Ms. Grace Suyanti Muliawan 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.

PECOS PAC ID6305251307
PECOS Enrollment IDI20210225002343
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

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.

Urinalysis, manual test 81002
A urinalysis is a simple, non-invasive test that checks the urine for various elements such as sugar, protein, and signs of infection. It can help detect many common conditions, including kidney disease and diabetes. The manual test involves a lab technician examining a urine sample.
14 services13 patients

Hospital Affiliations CMS Care Compare 2

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

St Luke's Regional Medical Center

Acute Care Hospitals · Boise, ID
5/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number130006
Location190 East Bannock StreetBoise, ID 83712 · Ada County
Emergency services Birthing friendly

Steele Memorial Medical Center

Critical Access Hospitals · Salmon, ID
OwnershipGovernment - Local
CMS Certification Number131305
LocationP O Box 700Salmon, ID 83467 · Lemhi County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 83226 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$81.13 typical visit price
range $52.44 – $160.17
Typical copayment $20.28 (range $13.11 – $40.04)
Most-billed visit code 99203
Established Patient
$65.77 typical visit price
range $16.68 – $130.93
Typical copayment $16.44 (range $4.17 – $32.73)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 7

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

CHALLIS AREA HEALTH CENTER INCORPORATED
Clinic/Center (Federally Qualified Health Center (FQHC))
611 CLINIC RD
CHALLIS, ID 83226
Custer County (208) 879-4351
GAY M MIREMONT LCSW
Social Worker (Clinical)
611 CLINIC RD
CHALLIS, ID 83226
Custer County (208) 879-4351
MR. MATTHEW CHAD BANKS PA-C
Physician Assistant
611 CLINIC RD
CHALLIS, ID 83226
Custer County (208) 879-4351
SHARON ROTAX LMSW
Social Worker
611 CLINIC RD
CHALLIS, ID 83226
Custer County (208) 879-4351
THOMAS DANIEL FIFE PA-C
Physician Assistant (Medical)
611 CLINIC RD
CHALLIS, ID 83226
Custer County (208) 879-4351
MILES ALAN HAEBERLE PHYSICIAN ASSISTANT
Physician Assistant
611 CLINIC RD
CHALLIS, ID 83226
Custer County (208) 879-4351
NORTH CUSTER HOSPITAL DISTRICT
Ambulance (Land Transport)
611 CLINIC RD
CHALLIS, ID 83226
Custer County (208) 879-2883

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 Grace Muliawan's NPI number?

The NPI number for Grace Muliawan is 1649879081. It was assigned to this individual provider in the NPPES registry on October 17, 2020.

Where is Grace Muliawan located?

Grace Muliawan practices at 611 Clinic Rd, Challis, ID 83226. The listed phone number is (208) 879-4351.

What is Grace Muliawan's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Is Grace Muliawan enrolled in Medicare?

Yes. Grace Muliawan 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 Grace Muliawan accept?

Health plans from Providence Health Plan list Grace Muliawan 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 Grace Muliawan affiliated with any hospitals?

According to CMS data, Grace Muliawan is affiliated with St Luke's Regional Medical Center and Steele Memorial Medical Center.

When was this NPI record last updated?

The NPPES record for Grace Muliawan was last updated on June 29, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 49 days 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.