Alysandra L Andrusky, PA-C

Individual provider Active NPI Surgical Physician Assistant · Hermitage, PA

NPI 1366075541 · NPPES record last updated Aug 27, 2020

Key facts

NPI
1366075541
Entity type
Individual (NPI type 1)
Primary specialty
Surgical Physician Assistant 363AS0400X
License
MA061275 (PA)
Practice address
3120 Highland Rd
Hermitage, PA 16148-4512
Phone
(724) 342-2663
NPI assigned
Feb 17, 2020
Sex
Female
Sole proprietor
No

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 and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in PA

Medicare enrollment records

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

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Physician Assistant

Specialties & licenses

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

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

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

Other providers in Hermitage, PA

All providers in Hermitage, PA · Surgical Physician Assistant in Pennsylvania

Sources for this page

Verify at the official NPI Registry.