Aleksandr Anatolyevich Kasyanchuk

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

AP61482837 Issued in WA

Practice address

320 S Kitsap Blvd
Port Orchard, WA 98366-3778

Phone

(360) 377-3776

NPI assigned

Sep 13, 2023

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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

• Quinault Indian Nation

  • Student in an Organized Health Care Education/Training Program
  • Aberdeen, WA
  • NPI 1134842636

  TX

  Medicare reassignment NPD
• Quinault Indian Nation

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Aberdeen, WA
  • NPI 1124860283
  NPD
• Quinault Indian Nation

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Aberdeen, WA
  • NPI 1881320711
  NPD

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

{
    "created_epoch": "1694563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694563200000",
    "number": "1124805031",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14134 110TH AVE NE",
            "city": "KIRKLAND",
            "state": "WA",
            "postal_code": "980344480"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "320 S KITSAP BLVD",
            "city": "PORT ORCHARD",
            "state": "WA",
            "postal_code": "983663778",
            "telephone_number": "360-377-3776"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KASYANCHUK",
        "first_name": "ALEKSANDR",
        "middle_name": "ANATOLYEVICH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-09-13",
        "last_updated": "2023-09-13",
        "certification_date": "2023-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "WA",
            "license": "AP61482837",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Barbara E Karbassi, DDS
• Karen C Lindner PHD PS
• Karlie a Gaskins DDS PLLC
• Kassuhn Inc
• Betty C. Kassuhn, CDP
• August Kelemen-Eberhart, LSWAIC
• Andrea Keller
• Trent Kelly, LMP
• Jennifer Kelso
• Khushwant Singh DDS PLLC

• Psychiatric/Mental Health Nurse Practitioner in Port Orchard, WA
• Providers in Port Orchard, WA by specialty
• Psychiatric/Mental Health Nurse Practitioner in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2023; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.