Individual provider Active NPI

Cynthia Chernyakhovsky, P.A.C.

  • Physician Assistant
  • Garland, TX
National Provider Identifier
1184712499
Registry record updated Mar 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA01701 Issued in TX
Practice address
700 Walter Reed Blvd
Suite 311
Garland, TX 75042-3701
Phone
(972) 487-6400
Fax
(972) 487-1686
NPI assigned
Oct 11, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA01701 TX
Physician Assistant 363A00000X PA01701 TX Primary

Addresses

Primary practice location

700 Walter Reed Blvd
Suite 311
Garland, TX 75042-3701

Mailing address

8022 Moss Meadows Dr
Dallas, TX 75231-3908
Phone (214) 553-9617

Other identifiers 1

IdentifierTypeStateIssuer
PA01701OtherTXSTATE LICENSE NUMBER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA01701TXMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Healthtexas Provider Network Past Accepting new patients
North Dallas Surgical Specialists, PA Past Accepting new patients

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": "1160524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741651200000",
    "number": "1184712499",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8022 MOSS MEADOWS DR",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752313908",
            "telephone_number": "214-553-9617"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 WALTER REED BLVD",
            "address_2": "SUITE 311",
            "city": "GARLAND",
            "state": "TX",
            "postal_code": "750423701",
            "telephone_number": "972-487-6400",
            "fax_number": "972-487-1686"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHERNYAKHOVSKY",
        "first_name": "CYNTHIA",
        "name_prefix": "Mrs.",
        "credential": "P.A.C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-11",
        "last_updated": "2025-03-11",
        "certification_date": "2025-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "TX",
            "license": "PA01701",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA01701",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE NUMBER",
            "identifier": "PA01701",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Garland, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.