Waleska Mikar Gontscharenko, SA-C

Primary specialty

Surgical AssistantTaxonomy code 246ZC0007X

License

21-113 Issued in TX

Practice address

8900 Red Bluff Rd Apt 2633
Pasadena, TX 77507-1152

Phone

(917) 514-3296

NPI assigned

Mar 28, 2021

Last updated

Mar 28, 2021By 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 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1616889600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616889600000",
    "number": "1538746169",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8900 RED BLUFF RD APT 2633",
            "city": "PASADENA",
            "state": "TX",
            "postal_code": "775071152",
            "telephone_number": "917-514-3296"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8900 RED BLUFF RD APT 2633",
            "city": "PASADENA",
            "state": "TX",
            "postal_code": "775071152",
            "telephone_number": "917-514-3296"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONTSCHARENKO",
        "first_name": "WALESKA",
        "middle_name": "MIKAR",
        "credential": "SA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-03-28",
        "last_updated": "2021-03-28",
        "certification_date": "2021-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "246ZC0007X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Other, Surgical Assistant",
            "state": "TX",
            "license": "21-113",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tanya C Godbold
• Rhizlane Rezoukia Godoy, NP
• Hannah Leigh Godwin, ATC, LAT
• Daniel Isser Goldman, M.D.
• Andrew Ekansh Gomes, MD
• Desiree Eileen Gonzales
• Jarrod Scott Gonzales, FNP-C
• Alicia Gonzalez Wiley
• Edith Gonzalez-Godinez, DO
• Claudia Gonzalez-Harmon, LPC

• Surgical Assistant in Pasadena, TX
• Providers in Pasadena, TX by specialty
• Surgical Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.