ATHENA MARIE KEOBOUNNAM PA-C
NPI 1982482816
Physician Assistant - Surgical in Fresno, CA

NPI Status: Active since September 20, 2023

Contact Information

7257 N FRESNO ST
FRESNO, CA
ZIP 93720
Phone: (559) 227-7463

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  • Individual
  • Female
  • Years of Experience 3
  • Physician Assistant
  • Surgical
  • Accepts Medicare Approved Payment
  • PECOS Enrolled

About ATHENA KEOBOUNNAM

This page provides the complete NPI Profile along with additional information for Athena Keobounnam, a provider established in Fresno, California with a medical specialization in Physician Assistant, focusing in surgical and more than 3 years of experience. The healthcare provider is registered in the NPI registry with number 1982482816 assigned on September 2023. The practitioner's primary taxonomy code is 363AS0400X with license number PA63422 (CA). The provider is registered as an individual and her NPI record was last updated 2 years ago.

NPI
1982482816
Provider Name
ATHENA MARIE KEOBOUNNAM PA-C
Gender
Female
Entity Type
Individual
Location Address
7257 N FRESNO ST FRESNO, CA 93720
Location Phone
(559) 227-7463
Mailing Address
4733 W VASSAR AVE FRESNO, CA 93722
Mailing Phone
(559) 367-3936
Medical School Name
OTHER
Graduation Year
2023
Is Sole Proprietor?
No
Enumeration Date
09-20-2023
Last Update Date
10-31-2023
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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.
PA63422
License State
CA

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)
1363A00000XPhysician Assistants & Advanced Practice Nursing Providers

Physician Assistant

 

Medicare Participation & PECOS Enrollment Status

Athena Keobounnam is registered with Medicare and accepts claims assignment, this means the provider accepts the approved amount for the cost of rendered services as full payment. Participating providers may not charge beneficiaries more than the approved amount for their services. Please keep in mind that beneficiaries still have to pay a coinsurance or copayment amount for a visit or service.

Athena Keobounnam 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

  • PECOS PAC ID: 4082060553

    What is the PECOS Associate Control ID?
    A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.

  • PECOS Enrollment ID: I20231020000351

    What is the Provider Enrollment ID?
    The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.

  • Accepts Medicare Assignment? Yes

    What does it mean "accepts medicare assignment"?
    When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
    A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.

  • 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

Reviews for ATHENA MARIE KEOBOUNNAM PA-C

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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.
1982482816
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
2916288482
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 9 + 1 + 6 + 2 + 8 + 8 + 4 + 8 + 2 + 24 = 74
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
80 - 74 = 66

The NPI number 1982482816 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 19 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1093718785DR. BRENT L KANE MD
Individual
Specialist7257 N FRESNO ST
FRESNO, CA 93720
(559) 447-4050
1194849679 PETER JEFFREY OGAWA PHARM.D.
Individual
Pharmacist7257 N FRESNO ST
FRESNO, CA 93720
(559) 451-3632
1467678656 MATTHEW JOHN ZOOLAKIS PHARM. D.
Individual
Pharmacist7257 N FRESNO ST
FRESNO, CA 93720
(559) 451-3632
1427377431 UMA G SWAMY MD
Individual
Radiology (Radiation Oncology)7257 N FRESNO ST
FRESNO, CA 93720
(559) 457-4050
1962464586RADIATION ONCOLOGY ASSOCIATES MEDICAL GROUP, INC. DBA. ONCOLOGY CARE P
Organization
Radiology (Radiation Oncology)7257 N FRESNO ST
FRESNO, CA 93720
(559) 447-4050
1548499619 LORI KOVACEVICH FNP
Individual
Nurse Practitioner (Family)7257 N FRESNO ST
FRESNO, CA 93720
(559) 447-4050
1801301973MRS. CRYSTAL LYNN RODRIGUEZ M.A. CCC-SLP
Individual
Speech-Language Pathologist7257 N FRESNO ST
FRESNO, CA 93720
(559) 451-3665
1033287818COMMUNITY ONCOLOGY ASSOCIATES MEDICAL GROUP, INC.
Organization
Specialist7257 N FRESNO ST
FRESNO, CA 93720
(559) 228-5444
1952912420COMMUNITY HEALTH PARTNERS
Organization
Clinic/Center (Multi-Specialty)7257 N FRESNO ST
FRESNO, CA 93720
(559) 324-4952
1235899931 HEATHER MARIE BRONIEC PA
Individual
Physician Assistant (Surgical)7257 N FRESNO ST
FRESNO, CA 93720
(559) 227-7463
1124558267DR. DMITRY DMITRIYEVICH BELCHENKO DO
Individual
Psychiatry & Neurology (Neurology)7257 N FRESNO ST
FRESNO, CA 93720
(559) 227-7463
1700288057 NOORIE PEDNEKAR
Individual
Psychiatry & Neurology (Neurology)7257 N FRESNO ST
FRESNO, CA 93720
(559) 227-7463
1164984704 RAHUL CHUG DO
Individual
Internal Medicine7257 N FRESNO ST
FRESNO, CA 93720
(559) 451-3638
1629574744 LINDA JO DO
Individual
Internal Medicine7257 N FRESNO ST
FRESNO, CA 93720
(559) 447-4050
1437647583 MOHONA REZA
Individual
Psychiatry & Neurology (Neurology)7257 N FRESNO ST
FRESNO, CA 93720
(559) 227-7463
1972098275 AMANUEL A KEBEDE MD
Individual
Psychiatry & Neurology (Neurology)7257 N FRESNO ST
FRESNO, CA 93720
(559) 451-3699
1457631830DR. VIKTORIYA SAMARINA PH.D.
Individual
Clinical Neuropsychologist7257 N FRESNO ST
FRESNO, CA 93720
(559) 222-7246
1396485561 ROCIO ANTONIA ESTRADA PA-C
Individual
Physician Assistant7257 N FRESNO ST
FRESNO, CA 93720
(559) 222-7246
1720540149 MARISSA URBANO
Individual
Psychiatry & Neurology (Neurology)7257 N FRESNO ST
FRESNO, CA 93720
(559) 222-7246

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1982482816, enumerated in the NPI registry as an "individual" on September 20, 2023

The provider is located at 7257 N Fresno St Fresno, Ca 93720 and the phone number is (559) 227-7463

The provider's speciality is Physician Assistant with taxonomy code 363AS0400X with a focus in Surgical

The provider has more than 3 years of experience.

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 September 20, 2023. 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].
NPI Profile data is regularly updated with the latest NPI registry information, if you would like to update or remove your NPI Profile in this website please contact us.