Active NPI
Alexander Avdashenko, PA-C
- Physician Assistant
- New York, NY
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 0010-14359
- Practice address
- 100 East 77TH Street
New York, NY 10021-1883 - Phone
- (917) 541-5378
- NPI assigned
- Oct 19, 2007
- Last updated
- Feb 23, 2026
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 0010-14359 | NC | Primary |
| Physician Assistant | 363A00000X | 012117 | NY |
Addresses
Primary practice location
100 East 77TH Street
New York, NY 10021-1883
Mailing address
2006 Benson Ave Apt 3G
Brooklyn, NY 11214-4826
Phone (917) 541-5378
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY, NC
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2007
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
180 Myrtle Ave
Brooklyn, NY 11201-7059
Phone (718) 650-2233
200 Livingston St
Brooklyn, NY 11201-5811
Phone (718) 522-3399
2315 3Rd Ave
New York, NY 10035-1733
Phone (212) 540-5020
260 Ave X
Brooklyn, NY 11223-5940
Phone (718) 336-8855
3000 New Bern Ave
Raleigh, NC 27610-1231
Phone (919) 350-7270
425 Westchester Ave
Bronx, NY 10455-1795
Phone (718) 705-2555
770 Flatbush Ave
Brooklyn, NY 11226-1902
Phone (347) 627-3988
827 11TH Ave
New York, NY 10019-3535
Phone (212) 369-5566
Hospital & facility affiliations
Merit-based Incentive Payment System (MIPS)
- Final score
- 93.07 of 100
- Quality
- 79.77
- Promoting interoperability
- 88.77
- Improvement activities
- 40
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0010-14359 | NC | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| North Shore-Lij Medical PC | Current | Accepting new patients | |
| Wakemed Specialists Group LLC | Current | Accepting new patients | |
| Wakemed Specialists Group, LLC | Current | Accepting new patients | |
| Wakemed Specialists Group, LLC | Current | Accepting new patients |
Locations
3000 New Bern Ave
Raleigh, NC 27610
Phone (919) 350-7000
3324 Six Forks Rd
Raleigh, NC 27609
Phone (919) 781-7772
10201 66th Rd
Forest Hills, NY 11375
Phone (718) 830-4091
300 Community Dr
Manhasset, NY 11030
100 E 77th St
New York, NY 10075
Phone (212) 434-2606
972 Brush Hollow Rd
Westbury, NY 11590
Networks
- Healthfirst Medicare Network H5989
- Healthfirst Medicare Network H1722
- Healthfirst Medicare Network H9678
- Healthfirst Medicare Network H3359
Interoperability endpoints
- aavdashenko23511@northwell.direct-ci.com
- aavdashenko601582@directhisp.wakemed.org
Organizations & group practices 5
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.
-
- Cardiovascular Disease Physician
- Raleigh, NC
- NPI 1588227839
-
- Health Service Clinic/Center
- Brooklyn, NY
- NPI 1144399098
-
dba NHPP Cardiology at Great Neck
- Urology Physician
- Great Neck, NY
- NPI 1053688572
-
dba WakeMed - Virtual Cardiac Rehab
- Cardiac Rehabilitation Registered Nurse
- Raleigh, NC
- NPI 1063304228
-
- Cardiovascular Disease Physician
- Raleigh, NC
- NPI 1104480532
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba WakeMed Mental Health & Well-Being Hospital WakeBrook
- Psychiatric Hospital Unit
- Raleigh, NC
- NPI 1780446302
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1192752000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1771804800000",
"number": "1699964262",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2006 BENSON AVE APT 3G",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112144826",
"telephone_number": "917-541-5378"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 EAST 77TH STREET",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100211883",
"telephone_number": "917-541-5378"
}
],
"practiceLocations": [],
"basic": {
"last_name": "AVDASHENKO",
"first_name": "ALEXANDER",
"name_prefix": "Mr.",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-10-19",
"last_updated": "2026-02-23",
"certification_date": "2026-02-23",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "NC",
"license": "0010-14359",
"primary": true
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "NY",
"license": "012117",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in New York, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2026; 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.