IndividualActiveAccepts Medicare

Alexander Gouttsoul, PA-C

NPI 1306154653 · Physician Assistant · Salt Lake City, UT

Enrolled with Medicare as Practitioner - Physician Assistant · source: CMS PECOS Public Provider Enrollment (2026.04.01)

Provider details

NPI number: 1306154653
Entity type: Individual
Primary specialty: Physician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Credential: PA-C
Sex: Male
Sole proprietor: No
License: 7776119-1206 (UT)

Specialties & taxonomies

Physician AssistantPrimary363A00000XLicense 7776119-1206 (UT)
Physician Assistants & Advanced Practice Nursing Providers
Medical Physician Assistant363AM0700XLicense 7776119-1206 (UT)
Physician Assistants & Advanced Practice Nursing Providers

Profile Score

Established profile(64/100 index)

A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.

Registry tenure28% of score
15 yrs in NPPES registry
Profile completeness28% of score
100% of core fields populated
Practice footprint17% of score
1 documented practice location
Medicare service volume (vs. specialty peers)28% of score
154 Medicare services, 2024 (ranked within specialty)

Medicare volume is ranked against active providers in the same specialty. Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.

What this provider does (Medicare)

Based on Medicare fee-for-service claims, 2024; not all care is captured.

Service (HCPCS)	Medicare services	Typical Medicare-allowed (2024)
Initial Hospital Care With Moderate Level of Medical Decision Making, If Using Time, at Least 75 Minutes99223	89	$142
Prolonged Hospital Inpatient Or Observation Care Evaluation and Management Service(s) Beyond the Total Time for the Primary Service (when the Primary Service Has Been Selected Using Time on the Date of the Primary Service); Each Additional 15 Minutes By ThG0316	52	$25
Subsequent Hospital Care With Moderate Levelof Medical Decision Making, If Using Time, at Least 50 Minutes99233	13	$97

Typical Medicare-allowed amounts for these services range $25–$142 (2024). The Medicare-allowed amount is what Medicare recognizes for a service under fee-for-service — a reference figure for 2024, not a price quote and not what you would be billed. Medicare Part B covers roughly an eighth of all NPIs (65+ skew); services with fewer than 11 beneficiaries are suppressed by CMS. Source: CMS Medicare Physician & Other Practitioners, by Provider & Service.

Practice location

30 N 1900 E

Salt Lake City, UT 84132-0002

Phone: (801) 585-1935

Fax: (801) 587-5872

Street-level locationGet directions

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Mailing address