Anya Peysakhovich, PA-C

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

58169 Issued in CA

Practice address

21 Tamal Vista Blvd Ste 103
Corte Madera, CA 94925-1133

Phone

(415) 927-7660

Fax

(415) 927-7663

NPI assigned

Jul 2, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Ms. Anya Panyushenko Former name

Medicare fee-for-service enrollment

Enrolled in NY, CA2 enrollments

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 2

Specialty

Physician Assistant

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Khashayar Mohebali MD a Medical CorporationGroup PAC ID 6800037334, 2 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Marinhealth Medical Center Hospital, Greenbrae, CA, CCN 050360

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/R4/
• Direct secure messaging: apeysakhovich555949@hisp.ehr.sutterhealth.org
• FHIR API: https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/DSTU2/

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.

• Khashayar Mohebali MD a Medical Corporation

  • Plastic Surgery Physician
  • Corte Madera, CA
  • NPI 1881030484
  Medicare reassignment Care Compare group
• Trustees of Columbia University in the City of New York

  • Surgery Physician
  • New York, NY
  • NPI 1508266347
  Medicare reassignment NPD (past)
• The Trustees of Columbia University in the City of New York

  • Surgery Physician
  • New York, NY
  • NPI 1265598783
  Medicare reassignment
• Trustees of Columbia University in the City of New York

  • Internal Medicine Physician
  • New York, NY
  • NPI 1699289488
  NPD
• Trustees of Columbia University in the City of New York

  • Internal Medicine Physician
  • New York, NY
  • NPI 1861907321
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Marin General Hospital

  • General Acute Care Hospital
  • Greenbrae, CA
  • NPI 1396725677
  Care Compare affiliation

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

{
    "created_epoch": "1530489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600128000000",
    "number": "1215423363",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21 TAMAL VISTA BLVD STE 103",
            "city": "CORTE MADERA",
            "state": "CA",
            "postal_code": "949251133",
            "telephone_number": "415-927-7660",
            "fax_number": "415-927-7663"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 TAMAL VISTA BLVD STE 103",
            "city": "CORTE MADERA",
            "state": "CA",
            "postal_code": "949251133",
            "telephone_number": "415-927-7660",
            "fax_number": "415-927-7663"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEYSAKHOVICH",
        "first_name": "ANYA",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-02",
        "last_updated": "2020-09-15",
        "certification_date": "2020-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "CA",
            "license": "58169",
            "primary": true
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NY",
            "license": "022137",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANYA",
            "last_name": "PANYUSHENKO",
            "prefix": "MS.",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Peterman Psychological Services, PC
• Jeremy Peterman
• Katherine Peterman
• Alexis Christine Petrakis, PSY.D.
• Nicole Petrosky, PA-C
• Kristine L. Pfleiderer, D.M.H.
• Alexandra Phelps, MA
• Physiotherapy Associates, Inc. (Select Physical Therapy)
• Jonathan Pofsky, MFT
• Erica Anne Posner, MFT

• Surgical Physician Assistant in Corte Madera, CA
• Providers in Corte Madera, CA by specialty
• Surgical Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2020; 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.
• 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.