Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Spencer Pili Laulusa, PA

Individual provider Physician Assistant · NPI 1447831961

Spencer Pili Laulusa, PA is a Physician Assistant in Provo, Utah. Qualified in 2021, 5 years ago. Practices with Revere Health PC, a 410-clinician group, works from 3 locations and accepts Medicare assignment. Licensed in Utah.

Years since qualifying
5
Licensed in
UT
In the registry since
2021
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

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Practice location Address checks out

395 W Cougar Blvd Ste 205
Provo, UT 84604-3328
Phone: (801) 357-1770
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (2)

  • 700 W 800 N, Orem, UT 84057-6301 — (801) 373-7350
  • 1055 N 500 W, Provo, UT 84604-3305 — (801) 373-7350

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 12456226-1206 (UT)

Record details

NPI number1447831961
Entity typeIndividual (Type 1)
GenderMale
Credentials PA
Sole proprietorNo
NPI enumeratedApril 16, 2021
Last updated in NPPESMay 13, 2026
Certification dateMay 13, 2026

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2021 (5 years in practice)
Group practice Revere Health Pc — 410 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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