Individual provider Active NPI

Alexandria Grechko, PA-C

  • Physician Assistant
  • Walnut Creek, CA
National Provider Identifier
1447619051
Registry record updated May 16, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
53210 Issued in CA
Practice address
1990 N California Blvd Ste 400
Walnut Creek, CA 94596-7249
Phone
(925) 482-2825
NPI assigned
Feb 11, 2016
Last updated
May 16, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 16, 2016

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 53210 CA Primary

Addresses

Primary practice location

1990 N California Blvd Ste 400
Walnut Creek, CA 94596-7249

Mailing address

2601 Catalina Dr
Davis, CA 95616-0263
Phone (949) 293-9527

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
I20160527000429 CA Practitioner - Physician Assistant 1850681156 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
88.38 of 100Reported as group
Quality
77.6
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
53210CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Cep America - California CurrentSince Jun 1, 2016 Accepting new patients
Cep America-California CurrentSince Jun 1, 2016 Accepting new patients

Locations

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

1 Medical Plaza Dr
Roseville, CA 95661
Phone (916) 781-1000

Organizations & group practices 4

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": "1455148800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1463356800000",
    "number": "1447619051",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2601 CATALINA DR",
            "city": "DAVIS",
            "state": "CA",
            "postal_code": "956160263",
            "telephone_number": "949-293-9527"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1990 N CALIFORNIA BLVD STE 400",
            "city": "WALNUT CREEK",
            "state": "CA",
            "postal_code": "945967249",
            "telephone_number": "925-482-2825"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRECHKO",
        "first_name": "ALEXANDRIA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-02-11",
        "last_updated": "2016-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "53210",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Walnut Creek, CA

Sources for this page

Verify at the official NPI Registry.