Daniel Zackary Souvannarath
Physician Assistant · Bridgeton, MO
Daniel Zackary Souvannarath is a physician assistant with a practice address in Bridgeton, Missouri, and NPI 1174144828, issued on May 5, 2020. Check the license (Missouri 2021010216, as entered in NPPES) with the Missouri board that licenses this profession; the Medicare figures below come from public CMS files.
- Name
- Daniel Zackary Souvannarath
- Primary taxonomy
- Physician Assistant 363A00000X
- License number
- 2021010216 MO
Self-reported in NPPES; status is on the state search - Practice location
- 12266 DE Paul Dr Ste 310, Bridgeton, MO 63044
- Phone
- (314) 209-5171
- Enumerated
- May 5, 2020
- Record last updated
- Sep 13, 2021 (not updated in 5 years: call before relying on the address or phone)
- Entity
- Type 1 · individual
8 nearest physician assistant records → All 1,790 in Missouri → Look up another NPI →
Also registered at 12266 DE Paul Dr Ste 310
A shared address usually means a shared clinic or building; it does not show who employs whom.
- Andrea Baxter, MDFamily Medicine Physician1518984053
Verify Daniel Zackary Souvannarath in five checks
- 1IdentityNPI record in CMS NPPESNPI lookupConfirmed in NPPES
- 2LicenseActive license and public ordersWhich Missouri board licenses this profession
Search for license 2021010216Check the board - 3Other statesLicenses and actions elsewhereDocInfo (FSMB)Not checked
- 4ExclusionsMedicare and Medicaid bansHHS-OIG exclusion listNot checked
- 5CertificationBoard certificationABMS AOA NCCPA AANPNot checked
94% fewer Medicare Part D claims than the average physician assistant in 2024
53 Medicare Part D claims for 34 beneficiaries, against an average of 830 among the 101,058 providers of this specialty who prescribed in Part D. Brand-name drugs were 23% of claims.
Source: CMS Medicare Part D Prescribers by Provider and Drug, 2024 (data.cms.gov). Part D covers prescriptions for Medicare patients only; drugs with fewer than 11 claims are not published.
Industry payments in 2024: $28.96
1 payment: food and beverage; the largest payer was Regeneron Healthcare Solutions, Inc. The 64,719 providers of this specialty with any payment received $841.65 on average. Payments are reported by manufacturers, not by the provider, and are not a sign of wrongdoing.
Source: CMS Open Payments, program year 2024 (openpaymentsdata.cms.gov); average among providers of this specialty with at least one payment.
Daniel Zackary Souvannarath among 1,790 physician assistant records in Missouri
Daniel Zackary Souvannarath is one of 1,790 physician assistant records with a practice address in Missouri. 81% of them appear in a Medicare file (Part D prescribing, MIPS, Open Payments or Medicare group billing); this one does. Its NPI, issued in 2020, is newer than 57% of them.
- NPI issued2020 · 57% of these records are older, 37% newer
- In a Medicare fileYes · 81% of these records are
- In the CMS Doctors and Clinicians fileNo · 70% of these records are
- Record last updated2021 · 32% of these records were not updated in five years or more
Source: CMS NPPES, file of Aug 9, 2026, every record with primary taxonomy 363A00000X and a Missouri practice address; Medicare files: CMS Part D Prescribers 2024, MIPS 2023, Open Payments 2024, Doctors and Clinicians (data.cms.gov).
20 physician assistant records list a practice address in Bridgeton
They are 20 of the 1,095 NPPES records with a practice address in Bridgeton, and 1,790 physician assistant records in Missouri.
All 1,790 in Missouri → Every provider in Bridgeton → Physician Assistant nationwide →
The 8 physician assistant records with the nearest ZIP codes
- Shannon Bast, PABridgeton, MO 630441760946669
- Michele Bena, PA-CBridgeton, MO 630441720127012
- Elizabeth Bokermann, PABridgeton, MO 630441679968135
- Paul Diesfeld, PA-CBridgeton, MO 630441396796041
- Laura FischerBridgeton, MO 630441023638038
- Courtney Grodie, PABridgeton, MO 630441437590437
- Amber Johnson, PAC MMSBridgeton, MO 630441275706913
- Kimberly Luu, PABridgeton, MO 630441669553590
Common questions
What is Daniel Zackary Souvannarath's NPI number?
Daniel Zackary Souvannarath's National Provider Identifier (NPI) is 1174144828, issued on May 5, 2020. An NPI identifies a provider in billing; it is not a license.
Where is Daniel Zackary Souvannarath located?
The NPPES record lists a practice address at 12266 DE Paul Dr Ste 310, Bridgeton, MO, 63044. Phone: (314) 209-5171. Providers update this record themselves, so call before visiting.
How can I verify Daniel Zackary Souvannarath's license?
NPPES lists Missouri license number 2021010216, as entered by the provider. Search the Missouri board that licenses this profession; the NPPES record confirms identity only.
How much does Daniel Zackary Souvannarath prescribe under Medicare Part D?
In 2024, Daniel Zackary Souvannarath had 53 Medicare Part D claims for 34 beneficiaries; the average among physician assistant prescribers was 830. Part D covers Medicare prescriptions only.
Source: CMS National Plan and Provider Enumeration System (NPPES), file of Aug 9, 2026 (NPPES files on CMS.gov); NUCC Health Care Provider Taxonomy. Medicare files from data.cms.gov. An NPI identifies who bills; it is not a license.
Figures on PlainDoctor are read from the federal files each page names (CMS NPPES, Medicare Part D, MIPS, Open Payments; the HHS-OIG exclusion list only as counts) and from Census population estimates, with the file date shown beside them. See our editorial standards & corrections policy, the methodology behind these numbers, or report a data error. Data current as of Aug 9, 2026.