Individual provider Active NPI

Alexandra Marie Laursen, PA-C

  • Physician Assistant
  • Newport Beach, CA
National Provider Identifier
1255933818
Registry record updated May 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
446 Old Newport Blvd Ste 100
Newport Beach, CA 92663-4246
Phone
(949) 631-4327
NPI assigned
Nov 9, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 5, 2021

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 CA Primary

Addresses

Primary practice location

446 Old Newport Blvd Ste 100
Newport Beach, CA 92663-4246

Mailing address

446 Old Newport Blvd Ste 100
Newport Beach, CA 92663-4246
Phone (949) 631-4327

Other practice location 1

16030 Ventura Blvd Ste 150
Encino, CA 91436-2779
Phone (818) 501-2001

Other practice location 2

770 Pacific Coast Hwy
Seal Beach, CA 90740-6215
Phone (562) 270-4327

Other names 1

  • Alexandra Marie Slomowitz Former name

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20210607000287 CA Practitioner - Physician Assistant 4981004371 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

446 Old Newport Blvd
Newport Beach, CA 92663-4246

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
59312CAMDEndodontist

Practice roles

OrganizationSpecialtyStatusNew patients
Shohet Ear Associates Medical Group, Inc Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: alexandra.laursen.p1@direct.eardoctor.nextgenshare.com

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.

Hospital & facility affiliations 1

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": "1604880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620172800000",
    "number": "1255933818",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "446 OLD NEWPORT BLVD STE 100",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926634246",
            "telephone_number": "949-631-4327"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "446 OLD NEWPORT BLVD STE 100",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926634246",
            "telephone_number": "949-631-4327"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "16030 Ventura Blvd Ste 150",
            "address_purpose": "LOCATION",
            "city": "Encino",
            "state": "CA",
            "postal_code": "914362779",
            "country_code": "US",
            "telephone_number": "818-501-2001",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "770 Pacific Coast Hwy",
            "address_purpose": "LOCATION",
            "city": "Seal Beach",
            "state": "CA",
            "postal_code": "907406215",
            "country_code": "US",
            "telephone_number": "562-270-4327",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LAURSEN",
        "first_name": "ALEXANDRA",
        "middle_name": "MARIE",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-11-09",
        "last_updated": "2021-05-05",
        "certification_date": "2021-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ALEXANDRA",
            "last_name": "SLOMOWITZ",
            "middle_name": "MARIE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Newport Beach, CA

Sources for this page

Verify at the official NPI Registry.