Individual provider Active NPI

Alexandra Pchenitchnikova, DC

  • Chiropractor
  • Portland, OR
National Provider Identifier
1124897343
Registry record updated Jan 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
6360 Issued in OR
Practice address
913 SW 16TH Ave
Portland, OR 97205-1730
Phone
(503) 228-5000
NPI assigned
Dec 28, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 8, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 6360 OR Primary

Addresses

Primary practice location

913 SW 16TH Ave
Portland, OR 97205-1730

Mailing address

5240 SW 42ND Ave
Portland, OR 97221-3641
Phone (650) 722-0501

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241112004156 OR Practitioner - Chiropractic 5890226120 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Western States College of Chiropractic, 2023
Medicare assignment
May accept Medicare assignment
Group practices
Equilibrium LLCGroup PAC ID 1759454630, 3 clinicians

Practice addresses (Care Compare)

913 SW 16TH Ave
Portland, OR 97205-1730
Phone (503) 228-5000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6063ORMDClinical Social Worker
6360ORMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Equilibrium LLC Chiropractor CurrentSince Oct 2, 2024 Accepting new patients
Melissa Miesen, PC PastSince Dec 31, 2023 Accepting new patients

Locations

913 SW 16th Ave
Portland, OR 97205
Phone (503) 228-5000

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1703721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704672000000",
    "number": "1124897343",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5240 SW 42ND AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972213641",
            "telephone_number": "650-722-0501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "913 SW 16TH AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972051730",
            "telephone_number": "503-228-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PCHENITCHNIKOVA",
        "first_name": "ALEXANDRA",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-12-28",
        "last_updated": "2024-01-08",
        "certification_date": "2024-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "OR",
            "license": "6360",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.