Individual provider Active NPI

Asia Grishchuk, PA-C

  • Physician Assistant
  • Nixa, MO
National Provider Identifier
1154887032
Registry record updated Feb 15, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
2019005376 Issued in MO
Practice address
940 W Mount Vernon St Ste 100
Nixa, MO 65714-9613
Phone
(417) 724-5300
NPI assigned
Feb 15, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 15, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 2019005376 MO Primary

Addresses

Primary practice location

940 W Mount Vernon St Ste 100
Nixa, MO 65714-9613

Mailing address

940 W Mount Vernon St Ste 100
Nixa, MO 65714-9613
Phone (417) 724-5300

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20190222000323 MO Practitioner - Physician Assistant 5698014421 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lester E Cox Medical CentersGroup PAC ID 5799787784, 240 clinicians

Practice addresses (Care Compare)

1530 E Republic Rd
Springfield, MO 65804-6530
Phone (417) 269-9060

2750 S Campbell Ave
Coxhealth Center Campbell
Springfield, MO 65807-3506
Phone (417) 269-2281

Hospital & facility affiliations

  • Cox Medical Centers Hospital, Springfield, MO, CCN 260040

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Clinic Springfield Communities CurrentSince Mar 18, 2019 Accepting new patients
Mercy Clinic Springfield Communities CurrentSince Mar 18, 2019 Accepting new patients
Mercy Clinic Springfield Communities CurrentSince Mar 18, 2019 Accepting new patients
Lester E Cox Medical Centers CurrentSince Nov 20, 2023 Accepting new patients
Lester E Cox Medical Centers CurrentSince Nov 20, 2023 Accepting new patients
Lincoln County Hospital Past Accepting new patients
Lester E. Cox Medical Centers Past Accepting new patients

Locations

940 W Mount Vernon St
Ste 100
Nixa, MO 65714
Phone (417) 724-5220

1605 Martin Springs Dr
Rolla, MO 65401
Phone (573) 458-6379

1605 Martin Springs Dr
Ste 330
Rolla, MO 65401
Phone (573) 458-6379

620 S Glenstone Ave
Springfield, MO 65802
Phone (417) 829-4215

3801 S National Ave
Ste 1122
Springfield, MO 65807

2750 S Campbell Ave
Springfield, MO 65807
Phone (417) 269-2281

1530 E Republic Rd
Springfield, MO 65804
Phone (417) 269-1362

2115 S Fremont Ave
Ste 3050
Springfield, MO 65804
Phone (417) 820-3905

Organizations & group practices 9

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.

Hospital & facility affiliations 3

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": "1550188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1550188800000",
    "number": "1154887032",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "940 W MOUNT VERNON ST STE 100",
            "city": "NIXA",
            "state": "MO",
            "postal_code": "657149613",
            "telephone_number": "417-724-5300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "940 W MOUNT VERNON ST STE 100",
            "city": "NIXA",
            "state": "MO",
            "postal_code": "657149613",
            "telephone_number": "417-724-5300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRISHCHUK",
        "first_name": "ASIA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-02-15",
        "last_updated": "2019-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MO",
            "license": "2019005376",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Nixa, MO

Sources for this page

Verify at the official NPI Registry.