Individual provider Active NPI

Alexandra Vitek Cobo, ATC, PA-C

  • Surgical Physician Assistant
  • Raleigh, NC
National Provider Identifier
1679913727
Registry record updated Feb 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
0110005640 Issued in VA
Practice address
3009 New Bern Ave
Raleigh, NC 27610-1214
Phone
(919) 232-5020
NPI assigned
Jul 2, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 18, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X 2268 NC
Surgical Physician Assistant 363AS0400X 0110005640 VA Primary

Addresses

Primary practice location

3009 New Bern Ave
Raleigh, NC 27610-1214

Mailing address

2920 Highwoods Blvd
Raleigh, NC 27604-0010
Phone (877) 498-4490

Other identifiers 1

IdentifierTypeStateIssuer
1679913727MedicaidVA

Other names 1

  • Alexandra Vitek Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address acobo252455@directHISP.wakemed.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20190412000625 NC Practitioner - Physician Assistant 9133404288 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Yale University School of Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wakemed Specialists Group LLCGroup PAC ID 2466788377, 868 clinicians

Practice addresses (Care Compare)

10000 Falls of Neuse Rd
Raleigh, NC 27614-7838
Phone (919) 350-8000

1900 Kildaire Farm Rd
Cary, NC 27518-6616
Phone (919) 350-8000

3000 New Bern Ave
Raleigh, NC 27610-1231
Phone (919) 350-7270

Hospital & facility affiliations

  • Wakemed, Cary Hospital Hospital, Cary, NC, CCN 340173
  • Wakemed, Raleigh Campus Hospital, Raleigh, NC, CCN 340069

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0110005640VAMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Wakemed Specialists Group, LLC CurrentSince Aug 22, 2019 Accepting new patients
Wakemed Specialists Group LLC CurrentSince Aug 22, 2019 Accepting new patients

Locations

3000 New Bern Ave
Raleigh, NC 27610
Phone (919) 350-7000

10000 Falls of Neuse Rd
Raleigh, NC 27614
Phone (919) 350-1300

2920 Highwoods Blvd
Raleigh, NC 27604

3009 New Bern Ave
Raleigh, NC 27610
Phone (919) 232-5021

Interoperability endpoints

  • Direct secure messaging: acobo252455@directhisp.wakemed.org

Organizations & group practices 3

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.

Hospital & facility affiliations 3

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

NPI Registry JSON

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

{
    "created_epoch": "1372723200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613606400000",
    "number": "1679913727",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2920 HIGHWOODS BLVD",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276040010",
            "telephone_number": "877-498-4490"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3009 NEW BERN AVE",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276101214",
            "telephone_number": "919-232-5020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COBO",
        "first_name": "ALEXANDRA",
        "middle_name": "VITEK",
        "credential": "ATC, PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-07-02",
        "last_updated": "2021-02-18",
        "certification_date": "2021-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "NC",
            "license": "2268",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "VA",
            "license": "0110005640",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1679913727",
            "state": "VA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "acobo252455@directHISP.wakemed.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "XML",
            "address_1": "3009 New Bern Ave",
            "city": "Raleigh",
            "state": "NC",
            "country_code": "US",
            "postal_code": "276101214",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "ALEXANDRA",
            "last_name": "VITEK",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Raleigh, NC

Sources for this page

Verify at the official NPI Registry.