MRS. SAVANNAH MARIE MUISE (PA) – Medical Physician Assistant, NPI 1053169144

MRS. SAVANNAH MARIE MUISE (PA) is a healthcare provider. based in Provo, Utah. specializing in PHYSICIAN ASSISTANT. They hold the professional credentials PA. They hold a License No. PA66994 (CA). The NPI Number for MRS. SAVANNAH MARIE MUISE (PA) is 1053169144

Main info

Female
Sole Proprietor
1 Year Of Experience
Accepts Medicare Assignment
Name
MRS. SAVANNAH MARIE MUISE (PA)
NPI
1053169144
Phone
(801) 375-5125
Address
1800 Novell Pl
Enumeration Date
13 May 2024
Last Update Date
7 October 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
5102644026
Graduation Year
2025 (1 year ago)
PAC ID
2062900798
Group Practice PAC ID
6103739131
Professional Enrollment ID
I20251023002373
Address ID
CA945454339HA27200AVEX300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience33
Completeness85
Years active:2State licenses:1Digital endpointsOther names

1,981 PHYSICIAN ASSISTANT in UT

Provider Addresses for MRS. SAVANNAH MARIE MUISE (PA)

  • 1800 Novell Pl

    Provo, UT 846066171

    Phone: (801) 375-5125

    Type: Location

  • 179 N 700 W

    PROVO, UT 846012650

    Phone: (403) 915-3975

    Type: Mailing

  • 15 ALTARINDA RD STE 100

    ORINDA, CA 945632607

    Phone: (925) 253-1199

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2025-10-23

PECOS data refreshed: 2026-06-15

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20251023002373IPhysician AssistantCATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 84606)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 6103739131View full group profile
NameSpecialtyState
Emergency MedicineOH
Emergency MedicineMI
Emergency MedicineOH
Emergency MedicineCA
-DE
Critical Care (Intensivists), Anesthesiology, Emergency MedicineCA
Emergency MedicineCA
Emergency MedicineCA
-CA
Emergency MedicineCA

Reviews

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Frequently asked questions

Can I cross-check MRS. SAVANNAH MARIE MUISE (PA) using NPI 1053169144?
NPI 1053169144 belongs to MRS. SAVANNAH MARIE MUISE (PA); compare other details if you need extra assurance.
Would MRS. SAVANNAH MARIE MUISE (PA) appear as active to a payer?
You can treat MRS. SAVANNAH MARIE MUISE (PA) as active for directory purposes; confirm clinical privileges separately.
What area of care is associated with MRS. SAVANNAH MARIE MUISE (PA)?
MRS. SAVANNAH MARIE MUISE (PA)'s record emphasizes Medical Physician Assistant. Clinical services aligned with this taxonomy classification.
Is MRS. SAVANNAH MARIE MUISE (PA) located near Provo?
MRS. SAVANNAH MARIE MUISE (PA) currently maps to Provo, Utah in this extract.
Does inactive status remove historical data?
Historical rows can remain visible after status changes — read the dates carefully.

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