Individual provider Active NPI

Alysandra L Andrusky, PA-C

  • Surgical Physician Assistant
  • Hermitage, PA
National Provider Identifier
1366075541
Registry record updated Aug 27, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
MA061275 Issued in PA
Practice address
3120 Highland Rd
Hermitage, PA 16148-4512
Phone
(724) 342-2663
NPI assigned
Feb 17, 2020
Last updated
Aug 27, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X MA061275 PA Primary

Addresses

Primary practice location

3120 Highland Rd
Hermitage, PA 16148-4512

Mailing address

3120 Highland Rd
Hermitage, PA 16148-4512
Phone (724) 342-2663

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address alysandraandrusky@sopc.allscriptsdirect.net Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200707001743 PA Practitioner - Physician Assistant 1759704976 Reassigns benefits to 1 organization

National Provider Directory

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

Interoperability endpoints

  • Direct secure messaging: alysandraandrusky@sopc.allscriptsdirect.net

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1581897600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598486400000",
    "number": "1366075541",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3120 HIGHLAND RD",
            "city": "HERMITAGE",
            "state": "PA",
            "postal_code": "161484512",
            "telephone_number": "724-342-2663"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3120 HIGHLAND RD",
            "city": "HERMITAGE",
            "state": "PA",
            "postal_code": "161484512",
            "telephone_number": "724-342-2663"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDRUSKY",
        "first_name": "ALYSANDRA",
        "middle_name": "L",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-02-17",
        "last_updated": "2020-08-27",
        "certification_date": "2020-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "PA",
            "license": "MA061275",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "alysandraandrusky@sopc.allscriptsdirect.net",
            "affiliation": "N",
            "endpointDescription": "Allscripts EHR",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "3120 Highland Rd",
            "city": "Hermitage",
            "state": "PA",
            "country_code": "US",
            "postal_code": "161484512",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Hermitage, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.