Alexa Lee Beretski, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

MA052867 Issued in PA

Practice address

802 Jefferson Ave
Scranton, PA 18510-1038

Phone

(570) 346-7331

Fax

(570) 346-0411

NPI assigned

Nov 30, 2006

Sex

Female

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 PA

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

Physician Assistant

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.

• Commonwealth Physician Network LLC

  • Internal Medicine Physician
  • Kingston, PA
  • NPI 1003238635

  PA

  Medicare reassignment NPD
• Pediatric Associates of Kingston, LLC

  • Pediatrics Physician
  • Kingston, PA
  • NPI 1831201276
  NPD (past)
• Wayne Memorial Hospital

  • General Acute Care Hospital
  • Honesdale, PA
  • NPI 1124026182
  NPD (past)

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

{
    "created_epoch": "1164844800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1508371200000",
    "number": "1164590071",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "802 JEFFERSON AVE",
            "city": "SCRANTON",
            "state": "PA",
            "postal_code": "185101038",
            "telephone_number": "570-346-7331",
            "fax_number": "570-346-0411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "802 JEFFERSON AVE",
            "city": "SCRANTON",
            "state": "PA",
            "postal_code": "185101038",
            "telephone_number": "570-346-7331",
            "fax_number": "570-346-0411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERETSKI",
        "first_name": "ALEXA",
        "middle_name": "LEE",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-30",
        "last_updated": "2017-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA052867",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gretchen Bentler, MS, LPC
• Marissa Bentler
• Gary Adam Beppler, PHARM.D.
• Joseph F Berardelli, P.A.
• Melanie Rose Berdy, RDN
• Michelle Berman, MD
• Branden Thomas Berry
• Mary Ellen Berry, PA C
• Melissa Michelle Bertha, D.O.
• Kaelyn Besecker, LPN

• All providers in Scranton, PA
• Physician Assistant in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2017; 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.