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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.

SAMANTHA MIYUKI SUEOKA PA-C
NPI 1861283558
Physician Assistant in Salt Lake City, UT

Active since May 13, 2025PECOS Enrolled
2295 S FOOTHILL DR, SALT LAKE CITY, UT 84109(801) 486-3021(801) 485-6339 Get Directions Write a Review

NPPES record last updated: July 27, 2026. Verified against the NPPES registry weekly; last sync: September 13, 2026.

Record update history: Jul 27, 2026, May 13, 2025 (2 updates tracked since 2025).

About Samantha Miyuki Sueoka Pa-c NPPES

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

SAMANTHA MIYUKI SUEOKA PA-C (NPI 1861283558) is an individual physician assistant in Salt Lake City, Utah, licensed in Utah (14291199-1206) and active in the NPI registry since May 2025. The provider is enrolled in Medicare PECOS and maintains a secondary practice location in Salt Lake City.

NPPES Registry Identity

NPI1861283558
Entity TypeIndividual
Primary Taxonomy363A00000X
Provider Legal NameSAMANTHA MIYUKI SUEOKACredential: PA-C
Location Address2295 S FOOTHILL DRSalt Lake City, UT 84109-4000
Mailing Address326 E Shamrock DrMurray, UT 84107-3981 · (801) 808-2814
Phone(801) 486-3021
Fax(801) 485-6339
Sole ProprietorNo
Enumeration DateMay 13, 2025
Last NPPES UpdateJuly 27, 20262 updates tracked since enumeration
NPPES CertifiedJuly 27, 2026
✔ NPI 1861283558 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
License✔ Licensed in UT · 14291199-1206
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.
2295 S FOOTHILL DR, Salt Lake City, UT 84109
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Secondary Practice Location 1

Location 16360 S 3000 E Ste 100Salt Lake City, UT 84121-6924 · Phone (801) 365-1032 · Fax (801) 365-1036

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Samantha Miyuki Sueoka Pa-c is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 84109 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
$84.41 typical visit price
range $54.34 – $166.03
Typical copayment $21.10 (range $13.58 – $41.50)
Most-billed visit code 99203
Established Patient
$68.01 typical visit price
range $17.23 – $135.20
Typical copayment $17.00 (range $4.30 – $33.80)
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 11

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

GINTARE DAILEY PA-C
Physician Assistant
2295 S FOOTHILL DR
SALT LAKE CITY, UT 84109
Salt Lake County (801) 486-3021
JACQUELINE LEANN ROHRER MD
Family Medicine
2295 S FOOTHILL DR
SALT LAKE CITY, UT 84109
Salt Lake County (801) 486-3021
EMMA CROSSETT DPT
Physical Therapist
2295 S FOOTHILL DR
SALT LAKE CITY, UT 84109
Salt Lake County (801) 486-7542
ISSAC PENA-RENTERIA PA-C
Physician Assistant
2295 S FOOTHILL DR
SALT LAKE CITY, UT 84109
Salt Lake County (801) 486-3021
MADELEINE ELISE RUPERT NP
Nurse Practitioner (Primary Care)
2295 S FOOTHILL DR
SALT LAKE CITY, UT 84109
Salt Lake County (801) 486-3021
DAVID GORDON JOINER PT, DPT, OCS
Physical Therapist
2295 S FOOTHILL DR, SUITE 1
SALT LAKE CITY, UT 84109
Salt Lake County (801) 486-7542
TALLYA LLEWELYN DNP
Registered Nurse
2295 S FOOTHILL DR
SALT LAKE CITY, UT 84109
Salt Lake County (801) 486-3021
ANNA RUTH EVERETT PA
Physician Assistant
2295 S FOOTHILL DR
SALT LAKE CITY, UT 84109
Salt Lake County (801) 486-3021

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 Samantha Sueoka's NPI number?

The NPI number for Samantha Sueoka is 1861283558. It was assigned to this individual provider in the NPPES registry on May 13, 2025.

Where is Samantha Sueoka located?

Samantha Sueoka practices at 2295 S Foothill Dr, Salt Lake City, UT 84109. The listed phone number is (801) 486-3021.

What is Samantha Sueoka's specialty?

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

Is Samantha Sueoka enrolled in Medicare?

Yes. Samantha Sueoka is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Samantha Sueoka was last updated on July 27, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 51 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.