Alexis Nicole Koenig, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA65862 Issued in CA

Practice address

703 California St
Huntington Beach, CA 92648-4715

Phone

(801) 935-0105

NPI assigned

Dec 6, 2024

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

Medicare fee-for-service enrollment

Enrolled in CA

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

Specialty

Physician Assistant

Education

Other, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Brentview Medical IncGroup PAC ID 6608990742, 11 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Interoperability endpoints

• Direct secure messaging: alexis.koenig@4294.securemail.prognocis.com

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.

• Medhero San Clemente, a Professional Medical Corporation

  • Urgent Care Clinic/Center
  • San Clemente, CA
  • NPI 1558736520
  Medicare reassignment
• Brentview Medical Inc.

  • Urgent Care Clinic/Center
  • Los Angeles, CA
  • NPI 1447581350
  Care Compare group

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

{
    "created_epoch": "1733443200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775174400000",
    "number": "1215743992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "703 CALIFORNIA ST",
            "city": "HUNTINGTON BEACH",
            "state": "CA",
            "postal_code": "926484715"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "703 CALIFORNIA ST",
            "city": "HUNTINGTON BEACH",
            "state": "CA",
            "postal_code": "926484715",
            "telephone_number": "801-935-0105"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOENIG",
        "first_name": "ALEXIS",
        "middle_name": "NICOLE",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-12-06",
        "last_updated": "2026-04-03",
        "certification_date": "2026-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA65862",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lesley Anne Koch, PT
• Kathleen Kochalko, DPT
• Thomas Christopher Kockinis, MD
• Michael J Kodrich, ELECTROLOGIST
• Craig Curtis Koehler, DC
• Luke Koga
• Naoto Kojima
• Glenn Tetsuo Komae, D.D.S.
• Jamie Kondo
• Dawn Lee Koon, LVN

• Physician Assistant in Huntington Beach, CA
• Providers in Huntington Beach, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2026; 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.