RYAN THOMAS SUDWEEKS – Physician Assistant, NPI 1164165213

RYAN THOMAS SUDWEEKS is a healthcare provider. based in Salt lake city, Utah. specializing in PHYSICIAN ASSISTANT. They hold a License No. 14139378-1206 (UT). The NPI Number for RYAN THOMAS SUDWEEKS is 1164165213

Main info

Male
Sole Proprietor
2 Years Of Experience
Accepts Medicare Assignment
Name
RYAN THOMAS SUDWEEKS
NPI
1164165213
Phone
(801) 581-7766
Address
375 S CHIPETA WAY STE A
Enumeration Date
17 April 2022
Last Update Date
21 February 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
-
Graduation Year
2024 (2 years ago)
PAC ID
2365976339
Group Practice PAC ID
6406020049
Professional Enrollment ID
I20241113002335
Address ID
UT841177168SA4624XBLVD400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience37
Completeness75
Years active:4State licenses:1Digital endpointsOther names

1,971 PHYSICIAN ASSISTANT in UT

Provider Addresses for RYAN THOMAS SUDWEEKS

  • 375 S CHIPETA WAY STE A

    SALT LAKE CITY, UT 841081261

    Phone: (801) 581-7766

    Type: Mailing

  • PO BOX 912042

    ST GEORGE, UT 847912042

    Phone: (435) 215-0228

    Fax: (435) 986-7092

    Type: Mailing

  • 691 E 400 N STE 110

    VINEYARD, UT 840597509

    Phone: (385) 666-9600

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 2 Open Payments records for all available years, with a total value of $33.

Total Amount is formed as General ($33) + Research ($0) + Ownership ($0) = $33.

Last reported payment date: 2024-12-02 • Largest payer in this snapshot: ABBVIE INC. ($19).

Total Amount

$33

General + Research + Ownership

Payments

2

Total payment records

General Amount

$33

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-12-02

Latest reported date

Top Companies

Largest payers in this snapshot

CompanyAmount
ABBVIE INC.$19
Amgen Inc.$13
View all Open Payments →|Open Payments Risk Radar →

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: 2024-11-13

PECOS data refreshed: 2026-05-27

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
I20241113002335IPhysician AssistantUTTBD

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 84108)

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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: 6406020049View full group profile
NameSpecialtyState
Nurse PractitionerUT
Physical Therapist In Private PracticeUT
Physician AssistantMD
N E U R O L O G YWI
Nurse PractitionerUT
Nurse PractitionerUT
Nurse PractitionerUT
-UT
R H E U M A T O L O G YUT
Pain Management, Interventional Pain ManagementUT

Reviews

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Frequently asked questions

Can I use this page to confirm RYAN THOMAS SUDWEEKS's NPI?
Yes. RYAN THOMAS SUDWEEKS is listed with NPI 1164165213 in the public NPI dataset.
Can I rely on RYAN THOMAS SUDWEEKS being an active provider?
As of the registry snapshot, RYAN THOMAS SUDWEEKS is marked active.
What is RYAN THOMAS SUDWEEKS's primary classification?
Physician Assistant is the headline specialty for RYAN THOMAS SUDWEEKS here. Clinical services aligned with this taxonomy classification.
What address line appears for RYAN THOMAS SUDWEEKS?
RYAN THOMAS SUDWEEKS's geographic hint is Salt Lake City, Utah in our summary view.
Is the information about RYAN THOMAS SUDWEEKS up to date?
Data updates when providers file changes in NPPES — treat critical facts as "verify if unsure."

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