Alexa Tkachuck, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

9118975 Issued in FL

Practice address

2838 E Oakland Park Blvd
Fort Lauderdale, FL 33306-1814

Phone

(954) 564-0040

NPI assigned

Oct 9, 2024

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Interoperability endpoints

• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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.

• South Florida Surgical Specialists LLC

  • Surgery Physician
  • Coral Springs, FL
  • NPI 1952409963
  Medicare reassignment
• Skin and Cancer Associates

  • Dermatology Physician
  • Plantation, FL
  • NPI 1427017292
  NPD (past)

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

{
    "created_epoch": "1728432000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728432000000",
    "number": "1386463909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2838 E OAKLAND PARK BLVD",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333061814"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2838 E OAKLAND PARK BLVD",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333061814",
            "telephone_number": "954-564-0040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TKACHUCK",
        "first_name": "ALEXA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-10-09",
        "last_updated": "2024-10-09",
        "certification_date": "2024-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "9118975",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jaime Tinoco, ACUPUNCTURIST
• Maritza Ginette Tirado
• Cami L Tiska Caton, LCSW
• Caroline Teresa Tisot, PH.D.
• Carolina Tizon, AP
• TLC Dental - Ft. Lauderdale, LLC
• TLC Dental - Oral Surgery, PLLC
• TLC Dental - Orthodontics, LLC
• TLC Dental 4 Kids, LLC
• TLC Oxygen & Medical Supplies, Inc.

• Physician Assistant in Fort Lauderdale, FL
• Providers in Fort Lauderdale, FL by specialty
• Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2024; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.