Victoria A Yatsuknenko, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA1148 Issued in KY

Practice address

2307 River Rd Ste 101
Louisville, KY 40206-5000

Phone

(502) 583-6647

Fax

(502) 585-4824

NPI assigned

Oct 1, 2008

Last updated

Apr 12, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• Victoria Faulconer Former name

Medicare fee-for-service enrollment

Enrolled in KY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Central Kentucky Dermatology PLLCGroup PAC ID 2860869351, 3 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Baptist Health Lexington Hospital, Lexington, KY, CCN 180103

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as group

Quality

100

Promoting interoperability

100

Improvement activities

40

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as group

Quality

100

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Central Kentucky Dermatology PLLC

  • Dermatology Physician
  • Nicholasville, KY
  • NPI 1124741780
  Medicare reassignment Care Compare group
• Skin Group PLLC

  • MOHS-Micrographic Surgery Physician
  • Louisville, KY
  • NPI 1366564494
  Medicare reassignment
• Commonwealth Medical Care, LLC

  • Family Medicine Physician
  • Lexington, KY
  • NPI 1427583178
  NPD (past)
• Skin Group PLLC

  dba Dermatopathology Consultants

  • Dermatopathology Physician
  • Louisville, KY
  • NPI 1013925106
  NPD (past)
• The Skin Group PLLC

  • Dermatology Physician
  • Louisville, KY
  • NPI 1346010469
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Baptist Healthcare System, Inc

  dba Baptist Health Lexington

  • General Acute Care Hospital
  • Lexington, KY
  • NPI 1538244918
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1222819200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618185600000",
    "number": "1013168715",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2307 RIVER RD STE 101",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402065000",
            "telephone_number": "502-583-6647",
            "fax_number": "502-585-4824"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2307 RIVER RD STE 101",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402065000",
            "telephone_number": "502-583-6647",
            "fax_number": "502-585-4824"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1868 W Hebron Ln Ste 200",
            "address_purpose": "LOCATION",
            "city": "Shepherdsville",
            "state": "KY",
            "postal_code": "401657425",
            "country_code": "US",
            "telephone_number": "502-583-6647",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "989 Governors Ln Ste 180",
            "address_purpose": "LOCATION",
            "city": "Lexington",
            "state": "KY",
            "postal_code": "405131174",
            "country_code": "US",
            "telephone_number": "859-338-3958",
            "fax_number": "859-368-8135",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "YATSUKNENKO",
        "first_name": "VICTORIA",
        "middle_name": "A",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-10-01",
        "last_updated": "2021-04-12",
        "certification_date": "2021-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "KY",
            "license": "PA1148",
            "primary": true
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CUMBERLAND HEALTHCARE",
            "identifier": "C60483",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BLUE CROSS AND BLUE SHIELD",
            "identifier": "000000588926",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "VICTORIA",
            "last_name": "FAULCONER",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Nicholas Edwin Yates, MD
• Rita Yates
• Robert Brandon Yates
• Roxanne Yates, TCADC
• Trista Grace Yates
• Eli Yazigi
• Lu Ye, MD
• David R Yeager, PA
• Kevin Jessie Allen Yeager, BOH DSC. GDDENT
• Laura M Yeager, APRN

• Physician Assistant in Louisville, KY
• Providers in Louisville, KY by specialty
• Physician Assistant in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.