Ksenia Yuryevna Sokolova, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

126765 Issued in AK

Practice address

3765 E. Blue Lupine Dr. Suite D
Wasilla, AK 99654

Phone

(907) 707-1671

NPI assigned

May 15, 2016

Last updated

Jul 22, 2022By the provider in NPPES

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in AK

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, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Select Physical Therapy Holdings IncGroup PAC ID 9537076401, shared by 76 NPIs, 1,992 clinicians

Pioneer Peak Orthopedics LLCGroup PAC ID 8921318080, 12 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Mat-Su Regional Medical Center Hospital, Palmer, AK, CCN 020006

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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.

• Pioneer Peak Orthopedics LLC

  • Orthopaedic Surgery Physician
  • Wasilla, AK
  • NPI 1548639727
  Medicare reassignment Care Compare group
• Anchorage Neurosurgical Associates Inc

  • Neurological Surgery Physician
  • Anchorage, AK
  • NPI 1194775379
  Medicare reassignment

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Mat-Su Valley Medical Center LLC

  dba Mat-Su Regional Medical Center

  • General Acute Care Hospital
  • Palmer, AK
  • NPI 1417975061
  Care Compare affiliation

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

{
    "created_epoch": "1463270400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658448000000",
    "number": "1396192860",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3765 E. BLUE LUPINE DR. SUITE D",
            "city": "WASILLA",
            "state": "AK",
            "postal_code": "99654",
            "telephone_number": "907-707-1671"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3765 E. BLUE LUPINE DR. SUITE D",
            "city": "WASILLA",
            "state": "AK",
            "postal_code": "99654",
            "telephone_number": "907-707-1671"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOKOLOVA",
        "first_name": "KSENIA",
        "middle_name": "YURYEVNA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-05-15",
        "last_updated": "2022-07-22",
        "certification_date": "2022-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "AK",
            "license": "126765",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1725360",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Grace K Snider
• Kimball Snyder, DDS
• Theresa Marie Snyder
• Karl Robert Soderstrom
• Kurt Soeder, MS, PHARM.D.
• Ashley Nicole Solle
• Marsha Sommerville
• Alysa Sonnentag, APRN
• Jacqueline Sorto, PHARMD
• Christy Dawn South, MD

• Medical Physician Assistant in Wasilla, AK
• Providers in Wasilla, AK by specialty
• Medical Physician Assistant in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2022; 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.