Soutsada Konesavanh, PA-C
NPI 1417108606 · Medical Physician Assistant · Salt Lake City, UT
Enrolled with Medicare as Practitioner - Physician Assistant · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Soutsada Konesavanh, PA-C is a Medical Physician Assistant provider in Salt Lake City, UT (NPI 1417108606).
Provider details
- NPI number
- 1417108606
- Entity type
- Individual
- Primary specialty
- Medical Physician AssistantPhysician Assistants & Advanced Practice Nursing Providers
- Credential
- PA-C
- Sex
- Female
- Sole proprietor
- Yes
- License
- 7138480-1206 (UT)
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Physician Assistants & Advanced Practice Nursing Providers
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure28% of score
17 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
21 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) |
|---|---|---|
| Established Patient Office Or Other Outpatient Visit With Moderate Level of Decision Making, If Using Time, 30 Minutes Or More99214 | 21 | $81 |
Typical Medicare-allowed amounts for these services range $81–$81 (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
Mailing address
Registry dates
- Enumerated
- 2008-10-06
- Last updated
- 2021-11-17
- Certified
- 2021-11-17
Frequently asked questions
- What is Soutsada Konesavanh's NPI number?
- Soutsada Konesavanh's National Provider Identifier (NPI) is 1417108606, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What is Soutsada Konesavanh's specialty?
- Soutsada Konesavanh is listed in the NPPES registry with a primary specialty of Medical Physician Assistant (Physician Assistants & Advanced Practice Nursing Providers).
- Where is Soutsada Konesavanh located?
- Soutsada Konesavanh's practice location on file with NPPES is 100 Mario Capecchi Dr, Salt Lake City, UT 84112-8924.
- What is Soutsada Konesavanh's phone number?
- The practice phone number listed in the NPPES registry for Soutsada Konesavanh is (801) 585-2341.
- Does Soutsada Konesavanh accept Medicare?
- Soutsada Konesavanh is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Is Soutsada Konesavanh's NPI active?
- Yes — Soutsada Konesavanh's NPI (1417108606) is active in the NPPES registry as of the last update on 2021-11-17.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.