Independent US Healthcare Provider Directory & Public Medical Database Patient Guides

Phanthaboon J Phannavong , PA-C

Physician Assistant โ€ข Seattle, WA

Active NPI 1831850791 Individual Practitioner Male Practitioner Accepts Medicare assignment Telehealth (some services)
Practice location in NPPES

825 Eastlake Ave E
Seattle, WA 981094405

Call 2065205000 Location details and other listings
Medical Disclaimer

This profile restates public CMS/NPPES data; T-MedInfo gives no medical advice — consult a licensed professional, and call 911 for emergencies.

Practice Location & Contact Primary Location

Practice Address

825 Eastlake Ave E

Seattle, WA 981094405

Telephone 2065205000
Organization at the Same NPPES Address or Phone
Fred Hutchinson Cancer Center Facility NPI 1164493847

Matched by practice address or phone in NPPES. A shared address or phone does not confirm that this clinician works there.

Other Listings in Public Data

CMS Doctors and Clinicians lists 2 distinct group names: The Association Of University Physicians; Virginia Mason Medical Center. See the list

Source: CMS Doctors and Clinicians National Downloadable File, release date unavailable.

Listings do not confirm current availability, employment or a shared ownership network.

Medicare Profile & Education

Source: CMS Doctors and Clinicians National Downloadable File

Medical School

Eastern Virginia Medical School

Graduation Year

2022

Medicare patients

109 people with Original Medicare in 2024

Different Original Medicare patients in 2024; counts below 11 are hidden; this does not show availability or quality.

Source: CMS, Medicare Physician & Other Practitioners โ€“ by Provider, 2024.

Medicare-allowed amount

About $10,846 in 2024

The total amount Medicare approved for these services in 2024. It includes what Medicare paid and what patients or their other insurance owed, such as the deductible and coinsurance.

What this does not show: Medicare-allowed amount

This is not the clinician's income. Part of it can go to a clinic or group practice, staff, equipment or drugs. It is not the price you will pay.

Source: CMS, Medicare Physician & Other Practitioners โ€“ by Provider and Service, 2024.

Paid by Medicare

About $6,791 in 2024

The part of the Medicare-allowed amount that Medicare itself paid in 2024, after patients' deductibles and coinsurance.

What this does not show: Paid by Medicare

This is not the clinician's income and not a measure of quality.

Source: CMS, Medicare Physician & Other Practitioners โ€“ by Provider and Service, 2024.

30-day fills

133 standardized 30-day fills in 2024

CMS converts prescriptions to 30-day supplies so they can be compared. A 90-day prescription counts as about three 30-day fills.

What this does not show: 30-day fills

It is not a count of patients and not a measure of quality.

Part D drug cost

$2,420 in 2024

The total cost of these prescriptions in 2024, paid by Medicare drug plans, patients and other payers together.

What this does not show: Part D drug cost

A higher cost often reflects the type of medicines a specialty uses. It is not your out-of-pocket cost and not a measure of quality.

Source: CMS, Medicare Part D Prescribers โ€“ by Provider and Drug, 2024.

Industry payments (Open Payments)

No Open Payments records are listed for this clinician for 2021โ€“2025.

Guide: How to read an Open Payments record

Years since graduation

4 years (graduated 2022)

CMS Doctors and Clinicians data list 2022 as the year this clinician finished professional school.

What this does not show: Years since graduation

It is not the number of years in practice, and more years does not mean better care.

Source: CMS Doctors and Clinicians National Downloadable File.

NPI first issued

2022

The year this clinician's National Provider Identifier (NPI) was issued. An NPI is a unique 10-digit ID that US health care providers use for billing.

What this does not show: NPI first issued

NPIs have been issued only since 2005, so this year is not necessarily when the clinician started practicing.

Source: CMS NPPES NPI Registry.

Accepts Medicare assignment

CMS data list this clinician as accepting Medicare assignment. This means agreeing to take the Medicare-approved amount as full payment for covered services.

Medicare assignment applies to Original Medicare. It does not tell you whether the clinician is in a Medicare Advantage plan's network, accepts other insurance, or is taking new patients.

Source: CMS Doctors and Clinicians; Medicare.gov, โ€œDoes your provider accept Medicare as full payment?โ€

Guide: What Medicare assignment means

Telehealth (some services)

Recent Medicare claims show this clinician provided some services by telehealth, such as a video or phone visit.

What this does not show: Telehealth (some services)

It does not mean all services are offered by telehealth, or that telehealth is covered by your plan.

Source: CMS, Telehealth Indicator on Medicare Care Compare (fact sheet, January 2023); CMS Doctors and Clinicians.

Guide: How Medicare covers telehealth

Enrolled in Medicare (PECOS)

Phanthaboon Phannavong has a Medicare enrollment record in PECOS, the CMS system clinicians use to enroll so they can bill Medicare or order services for people with Medicare.

It does not show whether the clinician accepts assignment, is in your plan's network, or is taking new patients.

Source: CMS Medicare Fee-For-Service Public Provider Enrollment (PECOS); CMS Order and Referring file.

Guide: What Medicare enrollment (PECOS) means

Can order Medicare-covered services

CMS lists Phanthaboon Phannavong as eligible to order or refer Medicare Part B clinical laboratory and imaging services, durable medical equipment (DME) and home health services for people with Medicare.

What this does not show: Can order Medicare-covered services

It does not mean the clinician offers these services directly.

Source: CMS Medicare Fee-For-Service Public Provider Enrollment (PECOS); CMS Order and Referring file.

Guide: What ordering and referring status means

Compared with the same specialty in Seattle and Washington

Billing and prescribing volume is not a quality rating.

Medicare Part B services

Close to the middle for clinicians listed under Physician Assistant in Seattle, WA (2024, 354 clinicians with data). Median for this group: 148. Middle half: 56 to 321.

Fewer Medicare Part B services than 65% of clinicians listed under Physician Assistant in Washington (2024, 1,707 clinicians with data). Median for this group: 218. Middle half: 77 to 474.

Medicare-allowed amount

Close to the middle for clinicians listed under Physician Assistant in Seattle, WA (2024, 354 clinicians with data). Median for this group: $13,493. Middle half: $5,394 to $24,568.

A lower Medicare-allowed amount than 60% of clinicians listed under Physician Assistant in Washington (2024, 1,707 clinicians with data). Median for this group: $16,952. Middle half: $6,879 to $34,613.

Paid by Medicare

A lower Medicare payment amount than 60% of clinicians listed under Physician Assistant in Seattle, WA (2024, 354 clinicians with data). Median for this group: $9,797. Middle half: $3,900 to $18,525.

A lower Medicare payment amount than 65% of clinicians listed under Physician Assistant in Washington (2024, 1,707 clinicians with data). Median for this group: $12,488. Middle half: $4,857 to $25,122.

Medicare Part D prescriptions

Close to the middle for clinicians listed under Physician Assistant in Seattle, WA (2024, 369 clinicians with data). Median for this group: 108. Middle half: 33 to 318.

Fewer Part D prescriptions than 70% of clinicians listed under Physician Assistant in Washington (2024, 2,001 clinicians with data). Median for this group: 244. Middle half: 75 to 797.

Part D drug cost

Close to the middle for clinicians listed under Physician Assistant in Seattle, WA (2024, 369 clinicians with data). Median for this group: $1,701. Middle half: $311 to $22,712.

Close to the middle for clinicians listed under Physician Assistant in Washington (2024, 2,001 clinicians with data). Median for this group: $4,328. Middle half: $751 to $64,764.

828 active clinicians are listed under Physician Assistant with a practice address in Seattle, WA (3,718 in Washington).

Addresses are self-reported to NPPES and may be out of date.

Telehealth indicator in Seattle

19% of these 828 clinicians have the CMS telehealth indicator.

67.3% of these 828 clinicians are listed by CMS as accepting Medicare assignment.

Sources: CMS Medicare Physician & Other Practitioners (2024), CMS Medicare Part D Prescribers (2024), CMS Doctors and Clinicians, CMS NPPES NPI Registry. Specialty names follow the NUCC Health Care Provider Taxonomy.

Text: T-MedInfo ยท Report an error.

Performed Procedures & Service Volume

Services billed to Original Medicare Part B in 2024.

CMS Part B ยท Data Year 2024
Reporting Year:

CPTยฎ is a registered trademark of the American Medical Association. CPT codes, descriptions and other data only are copyright 2022โ€“2023 American Medical Association. All rights reserved. Applicable FARS/HHSARS apply. Descriptions of CPT codes are the AMA's CPT Consumer Friendly Descriptors as published by CMS in the Medicare Physician & Other Practitioners โ€“ by Provider and Service data, 2023โ€“2024; they are plain-language summaries, not for clinical coding or documentation. HCPCS Level II codes and descriptions are from CMS. Fee schedules, relative value units, conversion factors and/or related components are not assigned by the AMA, are not part of CPT, and the AMA is not recommending their use. The AMA does not directly or indirectly practice medicine or dispense medical services. The AMA assumes no liability for data contained or not contained herein.

HCPCS Code Services Patients Submitted Charge Medicare Allowed
99213 Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more
62 55 $235.00 $84.19
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more
47 44 $330.00 $115.85
36415 Insertion of needle into vein for collection of blood sample
21 16 $25.14 $8.65

Source: CMS Part B by Provider and Service, 2024; services under 11 beneficiaries omitted by CMS. Privacy limits

Submitted charges are billed amounts, not a price quote for your visit.

Medicare Part D Prescribing Profile & Medications

Medicare Part D prescriptions filled, including refills, in 2024.

CMS Part D ยท Data Year 2024
Prescription Year:
Brand Name Generic Name Prescriptions Day Supply Total Cost Patients
Atorvastatin Calcium Atorvastatin Calcium 23 1,410 $225.87 โ€”
Omeprazole Omeprazole 17 773 $243.89 โ€”
Glipizide Glipizide 16 480 $437.56 โ€”
Paxlovid Nirmatrelvir/Ritonavir 14 70 $1,428.97 14
Lisinopril Lisinopril 12 910 $83.89 โ€”

Source: CMS Part D by Provider and Drug, 2024; rows below 11 claims omitted by CMS; volume isn’t quality. Privacy limits

Specialties & License Numbers Reported to NPPES

Self-certified to NPPES: 2026-02-10
Physician Assistant Primary Specialty

NUCC Taxonomy Code: 363A00000X

License # reported to NPPES WA PA61358368

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.

Check License Status with the State Board License numbers are self-reported to NPPES; T-MedInfo does not confirm them against state records. Current status: Washington State Department of Health Provider Lookup.
Look Up on State Board Site

Medicare (PECOS) Enrollment & Ordering Eligibility

Source: CMS PECOS
Medicare FFS Enrollment Status Medicare Enrollment on File
CMS Provider Specialty

PRACTITIONER - PHYSICIAN ASSISTANT

Medicare Enrollment ID

I20221107001245

Enrollment State Jurisdiction

WA

PECOS Control ID

5698142594

Medicare Order & Referring Eligibility
Clinical Lab & Imaging (Part B) Eligible
Durable Medical Equipment (DME) Eligible
Home Health Agency (HHA) Eligible
Power Mobility Devices (PMD) Eligible

Sources: CMS Provider Enrollment and Order and Referring. Medicare enrollment is a billing status, not an accreditation or quality rating.

Medicare Group Practice Enrollments

Source: CMS Doctors and Clinicians National Downloadable File

Virginia Mason Medical Center

2671 Ne 46th St, Seattle, WA 981055041

Phone: 2065258000

Virginia Mason Medical Center

925 Seneca St, Seattle, WA 981012742

Phone: 2062236600

Virginia Mason Medical Center

4575 Sand Point Way Ne, Seattle, WA 981053999

Phone: 2065258000

The Association Of University Physicians

825 Eastlake Ave E, Seattle, WA 981094405

Phone: 2062881000

Clinicians Sharing This Practice Address or Phone

Clinicians sharing this NPPES address, phone or fax; a shared contact does not mean they work together.

39 listed
Dr. Meagan Alvarado , MD

Internal Medicine - Transplant Hepatology

NPI 1003303363

Doctor of Medicine (M.D.)

Kathryn Anderson , ARNP

Nurse Practitioner

NPI 1003331414

Advanced Registered Nurse Practitioner

Mir Mohammad Ali Ansary

Internal Medicine

NPI 1003235698
Jennifer Branham , ARNP

Nurse Practitioner

NPI 1003251273

Advanced Registered Nurse Practitioner

Timothy Butterworth , CRNA

Nurse Anesthetist, Certified Registered

NPI 1003325333

Certified Registered Nurse Anesthetist

Dr. Maria Corcorran , MD

Internal Medicine

NPI 1003159013

Doctor of Medicine (M.D.)

Career & Practice History Timeline

Changes recorded in monthly NPPES data files: addresses, names, credentials, specialties and NPI status

11 Historical Events
๐Ÿ“
Updated Practice Location February 10, 2026

Registered at 825 EASTLAKE AVE E, SEATTLE, WA 981094405 (Tel: 2065205000)

๐Ÿ“
Updated Business Mailing Address February 10, 2026

Registered at PO BOX 50095, SEATTLE, WA 981455095 (Tel: 2065205700)

๐Ÿ‘ค
Provider Name / Credentials Updated February 10, 2026

Recorded as PHANTHABOON PHANNAVONG, PA-C

๐Ÿ“
Updated Practice Location November 24, 2022

Registered at 2671 NE 46TH ST, SEATTLE, WA 981055041 (Tel: 2065258000)

๐ŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) October 25, 2022

Physician Assistant (license number reported to NPPES: WA PA61358368)

โœ…
NPI Profile Active January 04, 2022

NPI status registered as active in NPPES database

๐Ÿ“
Practice Location (Initial Record) January 04, 2022

Registered at 26413 LESLIE AVE, EUCLID, OH 441322527 (Tel: 2162501293)

๐Ÿ“
Business Mailing Address (Initial Record) January 04, 2022

Registered at 26413 LESLIE AVE, EUCLID, OH 441322527 (Tel: 2162501293)

๐Ÿ‘ค
Provider Name / Credentials (Initial Record) January 04, 2022

Recorded as PHANTHABOON PHANNAVONG

๐ŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) January 04, 2022

Student in an Organized Health Care Education/Training Program

๐ŸŸข
Initial NPI Registration & Enumeration January 04, 2022

First registered as active Individual Practitioner in NPPES Database.

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NPI Administrative Meta

NPI Number: 1831850791
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: January 04, 2022
Last Update: February 10, 2026
Sole Proprietor: No

Other Physician Assistants in Seattle

All Physician Assistants in Seattle

Mailing Address

Po Box 50095

Seattle, WA 981455095

Phone: 2065205700

About This Data NPPES fields (address, phone, specialty, license) are self-reported and may be outdated; Medicare fields follow the CMS dataset named in each section. Correct directly at NPPES.