Individual provider Active NPI

Alexandra Grace Breuhaus, PA-C

  • Medical Physician Assistant
  • Lynnwood, WA
National Provider Identifier
1083153043
Registry record updated Nov 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA61238106 Issued in WA
Practice address
19020 33Rd Ave W Ste 210
Lynnwood, WA 98036-4748
Phone
(425) 563-1500
Fax
(425) 563-1374
NPI assigned
Feb 22, 2017
Last updated
Nov 21, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 21, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA61238106 WA Primary

Addresses

Primary practice location

19020 33Rd Ave W Ste 210
Lynnwood, WA 98036-4748

Mailing address

19020 33Rd Ave W Ste 210
Lynnwood, WA 98036-4748
Phone (425) 563-1500

Other practice location 1

510 8th Ave NE Ste 110
Issaquah, WA 98029-5436
Phone (425) 507-0810

Other practice location 2

3101 Northup Way Ste 102
Bellevue, WA 98004-1469
Phone (425) 507-0810

Other identifiers 1

IdentifierTypeStateIssuer
2205668MedicaidWA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, WA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20181024002654 NY Practitioner - Physician Assistant 5395098107 Reassigns benefits to 1 organization
I20220427000675 WA Practitioner - Physician Assistant 5395098107 Reassigns benefits to 7 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Virginia Mason Medical CenterGroup PAC ID 9830002617, 867 clinicians

Practice addresses (Care Compare)

1100 9TH Ave
Seattle, WA 98101-2756
Phone (206) 223-6600

925 Seneca St
Seattle, WA 98101-2742
Phone (206) 223-6600

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
New York University CurrentSince Sep 3, 2018 Accepting new patients
Virginia Mason Medical Center CurrentSince Dec 19, 2024 Accepting new patients
Proliance Surgeons Inc P S CurrentSince Oct 22, 2023 Accepting new patients
New York University CurrentSince Sep 3, 2018 Accepting new patients
Proliance Surgeons, Inc., P.S. CurrentSince Oct 22, 2023 Accepting new patients
Radia Imaging Center Holdings LLC CurrentSince May 23, 2022 Accepting new patients
Virginia Mason Medical Center CurrentSince Dec 19, 2024 Accepting new patients
Radia Inc P S CurrentSince May 23, 2022 Accepting new patients

Locations

14 Wall St
Fl 9
Wall Street, NY 10005
Phone (646) 501-3224

380 Winslow Way E
Bainbridge Island, WA 98110
Phone (206) 842-5632

3101 Northup Way
Ste 102
Bellevue, WA 98004
Phone (425) 507-0810

21700 Highway 99
Edmonds, WA 98026
Phone (425) 640-4949

510 8th Ave NE
Ste 110
Issaquah, WA 98029
Phone (425) 507-0810

510 8th Ave NE
Ste 200
Issaquah, WA 98029
Phone (425) 392-3030

11521 NE 128th St
Ste 200
Kirkland, WA 98034
Phone (425) 952-6100

12040 NE 128th St
Kirkland, WA 98034
Phone (425) 899-1000

19020 33rd Ave W
Ste 210
Lynnwood, WA 98036
Phone 42556315001

1025 153rd St SE
Ste 200
Mill Creek, WA 98012
Phone (425) 338-4000

3417 Ensign Rd NE
Olympia, WA 98506
Phone (360) 493-4600

1100 9th Ave
Seattle, WA 98101
Phone (206) 223-6980

1229 Madison St
Ste 900
Seattle, WA 98104
Phone (206) 292-6233

500 17th Ave
Seattle, WA 98122
Phone (206) 320-2111

805 Madison St
Ste 901
Seattle, WA 98104
Phone (206) 264-8100

925 Seneca St
Seattle, WA 98101
Phone (206) 341-0860

4816 NE Thurston Way
Ste A
Vancouver, WA 98662
Phone (360) 254-4914

Organizations & group practices 13

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.

View all 13

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1487721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700524800000",
    "number": "1083153043",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19020 33RD AVE W STE 210",
            "city": "LYNNWOOD",
            "state": "WA",
            "postal_code": "980364748",
            "telephone_number": "425-563-1500",
            "fax_number": "425-563-1374"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19020 33RD AVE W STE 210",
            "city": "LYNNWOOD",
            "state": "WA",
            "postal_code": "980364748",
            "telephone_number": "425-563-1500",
            "fax_number": "425-563-1374"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "510 8th Ave NE Ste 110",
            "address_purpose": "LOCATION",
            "city": "Issaquah",
            "state": "WA",
            "postal_code": "980295436",
            "country_code": "US",
            "telephone_number": "425-507-0810",
            "fax_number": "425-507-0805",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3101 Northup Way Ste 102",
            "address_purpose": "LOCATION",
            "city": "Bellevue",
            "state": "WA",
            "postal_code": "980041469",
            "country_code": "US",
            "telephone_number": "425-507-0810",
            "fax_number": "425-507-0805",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BREUHAUS",
        "first_name": "ALEXANDRA",
        "middle_name": "GRACE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-02-22",
        "last_updated": "2023-11-21",
        "certification_date": "2023-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "WA",
            "license": "PA61238106",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2205668",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lynnwood, WA

Sources for this page

Verify at the official NPI Registry.