Sipong Patamasucon
Physician Assistant · Lake Havasu City, AZ
Sipong Patamasucon is a physician assistant with a practice address in Lake Havasu City, Arizona, and NPI 1316747256, issued on Mar 18, 2025. Check the license (Arizona 11017, as entered in NPPES) with the Arizona board that licenses this profession; the Medicare figures below come from public CMS files.
- Name
- Sipong Patamasucon
- Primary taxonomy
- Physician Assistant 363A00000X
- License number
- 11017 AZ
Self-reported in NPPES; status is on the state search - Practice location
- 1801 Mesquite Ave, Lake Havasu City, AZ 86403
- Phone
- (928) 854-5400
- Enumerated
- Mar 18, 2025
- Record last updated
- Mar 18, 2025
- Medicare enrollment
- Enrolled (PECOS I20250414001839); accepts Medicare assignment
- Entity
- Type 1 · individual
8 nearest physician assistant records → All 3,666 in Arizona → Look up another NPI →
Also registered at 1801 Mesquite Ave
A shared address usually means a shared clinic or building; it does not show who employs whom.
- Alice Dreyfus, APRN, FNP-BCFamily Nurse Practitioner1801286646
- Tejaswi Mudigonda, M.D.MOHS-Micrographic Surgery Physician1891143277
Verify Sipong Patamasucon in five checks
- 1IdentityNPI record in CMS NPPESNPI lookupConfirmed in NPPES
- 2LicenseActive license and public ordersWhich Arizona board licenses this profession
Search for license 11017Check the board - 3Other statesLicenses and actions elsewhereDocInfo (FSMB)Not checked
- 4ExclusionsMedicare and Medicaid bansHHS-OIG exclusion listNot checked
- 5CertificationBoard certificationABMS AOA NCCPA AANPNot checked
Bills Medicare through one group practice
- Thomas DermatologyLake Havasu City, AZ
Source: CMS Doctors and Clinicians National Downloadable File (the group practices a clinician bills Medicare through) (data.cms.gov).
Sipong Patamasucon among 3,666 physician assistant records in Arizona
Sipong Patamasucon is one of 3,666 physician assistant records with a practice address in Arizona. 77% of them appear in a Medicare file (Part D prescribing, MIPS, Open Payments or Medicare group billing); this one does. Its NPI, issued in 2025, is newer than 90% of them.
- NPI issued2025 · 90% of these records are older, 4% newer
- In a Medicare fileYes · 77% of these records are
- In the CMS Doctors and Clinicians fileYes · 60% of these records are
- Graduated2024 · median 2018 among the 2,207 with a school on file
- Record last updated2025 · 35% 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 Arizona practice address; Medicare files: CMS Part D Prescribers 2024, MIPS 2023, Open Payments 2024, Doctors and Clinicians (data.cms.gov).
21 physician assistant records list a practice address in Lake Havasu City
They are 21 of the 626 NPPES records with a practice address in Lake Havasu City, and 3,666 physician assistant records in Arizona.
All 3,666 in Arizona → Every provider in Lake Havasu City → Physician Assistant nationwide →
The 8 physician assistant records with the nearest ZIP codes
- Bridget Conley, PA-CLake Havasu City, AZ 864031598091944
- James Corbett, PA-CLake Havasu City, AZ 864031972577088
- Kyle Denman, PACLake Havasu City, AZ 864031750325411
- Kyle Fjerstad, P.A.C.Lake Havasu City, AZ 864031366862526
- Christian Grandell, PA-CLake Havasu City, AZ 864031588603542
- Nicole Guzzo, PACLake Havasu City, AZ 864031285920991
- Richard Holmes, PA-CLake Havasu City, AZ 864031467478396
- Janet Marinelli, PA-CLake Havasu City, AZ 864031093938128
Common questions
What is Sipong Patamasucon's NPI number?
Sipong Patamasucon's National Provider Identifier (NPI) is 1316747256, issued on Mar 18, 2025. An NPI identifies a provider in billing; it is not a license.
Where is Sipong Patamasucon located?
The NPPES record lists a practice address at 1801 Mesquite Ave, Lake Havasu City, AZ, 86403. Phone: (928) 854-5400. Providers update this record themselves, so call before visiting.
How can I verify Sipong Patamasucon's license?
NPPES lists Arizona license number 11017, as entered by the provider. Search the Arizona board that licenses this profession; the NPPES record confirms identity 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.