KHAUNSAVAN VONGPHAKDY PA
NPI 1609624006
Physician Assistant - Surgical in Evanston, IL
NPI Status: Active since May 09, 2024
- Individual
- Female
- Physician Assistant
- Surgical
- PECOS Enrolled
About KHAUNSAVAN VONGPHAKDY
This page provides the complete NPI Profile along with additional information for Khaunsavan Vongphakdy, a provider established in Evanston, Illinois with a medical specialization in Physician Assistant, focusing in surgical . The healthcare provider is registered in the NPI registry with number 1609624006 assigned on May 2024. The practitioner's primary taxonomy code is 363AS0400X with license number 085010441 (IL). The provider is registered as an individual and her NPI record was last updated one year ago.
- NPI
- 1609624006
- Provider Name
- KHAUNSAVAN VONGPHAKDY PA
- Gender
- Female
- Entity Type
- Individual
- Location Address
- 2650 RIDGE AVE EVANSTON, IL 60201
- Location Phone
- (847) 570-2000
- Mailing Address
- 2650 RIDGE AVE EVANSTON, IL 60201
- Mailing Phone
- (847) 570-2000
- Is Sole Proprietor?
- No
- Enumeration Date
- 05-09-2024
- Last Update Date
- 05-13-2024
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Physician Assistant Surgical
- Taxonomy Code
- 363AS0400X
- Type
- Physician Assistants & Advanced Practice Nursing Providers
- License No.
- 085010441
- License State
- IL
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
| No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
|---|---|---|---|---|
| 1 | 363A00000X | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant |
Medicare Participation & PECOS Enrollment Status
Khaunsavan Vongphakdy is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.
What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.
Is the provider registered in PECOS? Yes
Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes
Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes
Eligible to Order or Refer a Home Health Agency (HHA): Yes
Eligible to Order or Refer Power Mobility Devices: Yes
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NPI Validation Check Digit Calculation
The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.
| Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
| 1 | 6 | 0 | 9 | 6 | 2 | 4 | 0 | 0 | 6 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 6 | 0 | 9 | 12 | 2 | 8 | 0 | 0 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 6 + 0 + 9 + 1 + 2 + 2 + 8 + 0 + 0 + 24 = 54 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 60 - 54 = 6 | 6 | ||||||||
The NPI number 1609624006 is valid because the calculated check digit 6 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following 20 providers are registered at the same or nearby location.
| NPI | Name / Type | Taxonomy | Address |
|---|---|---|---|
| 1669476545 | STEVEN C SMART MD Individual | Internal Medicine (Cardiovascular Disease) | 2650 RIDGE AVE EVANSTON, IL 60201 (847) 570-2000 |
| 1437150471 | ANDREA PARKS PA-C Individual | Physician Assistant (Surgical) | 2650 RIDGE AVE DIVISION OF NEUROSURGERY EVANSTON, IL 60201 (847) 570-1440 |
| 1952386427 | MRS. GWEN GASSMAN FRALEY M.S., C.G.C. Individual | Genetic Counselor, MS | 2650 RIDGE AVE FETAL DIAGNOSTICS EVANSTON, IL 60201 (847) 570-2864 |
| 1699750174 | MS. ELIZABETH A. LEETH M.S. Individual | Genetic Counselor, MS | 2650 RIDGE AVE FETAL DIAGNOSTICS, RM 1400 EVANSTON, IL 60201 (847) 570-1380 |
| 1497714869 | DORIS LAI MING YIP M.D. Individual | Radiology (Neuroradiology) | 2650 RIDGE AVE DEPARTMENT OF RADIOLOGY, G507 EVANSTON, IL 60201 (847) 570-2475 |
| 1487606109 | PHILIP H SHERIDAN JR. MD Individual | Internal Medicine (Pulmonary Disease) | 2650 RIDGE AVE EVANSTON, IL 60201 (847) 675-1960 |
| 1700833522 | MS. ANNE P. SEBASTIAN PA Individual | Physician Assistant | 2650 RIDGE AVE BURCH 106 EVANSTON, IL 60201 (847) 570-1328 |
| 1619924313 | VANDANA SUSMI KULKARNI M.D. Individual | Anesthesiology | 2650 RIDGE AVE EVANSTON HOSPITAL RM 1210 EVANSTON, IL 60201 (847) 570-1206 |
| 1811944184 | TED E FELDMAN M.D. Individual | Internal Medicine (Cardiovascular Disease) | 2650 RIDGE AVE EVANSTON HOSPITAL RM 1210 EVANSTON, IL 60201 (847) 570-1206 |
| 1043267461 | MARK DIETERICH M.D. Individual | Pathology (Anatomic Pathology & Clinical Pathology) | 2650 RIDGE AVE EVANSTON HOSPITAL RM 1210 EVANSTON, IL 60201 (847) 570-1206 |
| 1205883485 | MOHAMED ELDIBANY MB, BCH Individual | Pathology (Anatomic Pathology & Clinical Pathology) | 2650 RIDGE AVE EVANSTON HOSPITAL RM 1210 EVANSTON, IL 60201 (847) 570-1206 |
| 1295772119 | PATRICK J GAVIN M.D. Individual | Pathology (Clinical Pathology/Laboratory Medicine) | 2650 RIDGE AVE EVANSTON HOSPITAL EVANSTON, IL 60201 (847) 570-1206 |
| 1194762013 | MALCOLM V VYE M.D. Individual | Pathology (Anatomic Pathology & Clinical Pathology) | 2650 RIDGE AVE EVANSTON HOSPITAL EVANSTON, IL 60201 (847) 570-2040 |
| 1922055144 | MICHELANGELO A MILANO M.D. Individual | Pathology (Anatomic Pathology) | 2650 RIDGE AVE EVANSTON HOSPITAL EVANSTON, IL 60201 (847) 570-1206 |
| 1376580704 | KRISTI K KILLELEA PHARM.D. Individual | Pharmacist (Pharmacotherapy) | 2650 RIDGE AVE INPATIENT PHARMACY EVANSTON, IL 60201 (847) 570-4113 |
| 1962441584 | VATHSALA T RAGHAVAN M.D. Individual | Specialist | 2650 RIDGE AVE EVANSTON, IL 60201 (847) 570-2590 |
| 1033158639 | WILLIAM DAVID BLOOMER M.D. Individual | Specialist | 2650 RIDGE AVE EVANSTON, IL 60201 (847) 570-2590 |
| 1487695045 | CURTIS RAY HALL M.D. Individual | Pathology (Anatomic Pathology & Clinical Pathology) | 2650 RIDGE AVE EVANSTON HOSPITAL RM 1210 EVANSTON, IL 60201 (847) 570-1206 |
| 1568403004 | DR. LISA MARIE MICHENER PHARM.D., M.S. Individual | Pharmacist | 2650 RIDGE AVE EVANSTON, IL 60201 (847) 570-1580 |
| 1639110992 | BARBARA M GOLDEN M.D. Individual | Pathology (Anatomic Pathology & Clinical Pathology) | 2650 RIDGE AVE EVANSTON HOSPITAL RM 1210 EVANSTON, IL 60201 (847) 570-1206 |
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1609624006, enumerated in the NPI registry as an "individual" on May 09, 2024
The provider is located at 2650 Ridge Ave Evanston, Il 60201 and the phone number is (847) 570-2000
The provider's speciality is Physician Assistant with taxonomy code 363AS0400X with a focus in Surgical
Yes, as of June 20, 2025 the provider is registered in PECOS and is eligible to order health care services or supplies for Medicare patients. If you are a beneficiary the provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.
This NPI record was last updated on May 09, 2024. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
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