Oksana Lelyukh Kostyukevich, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA63203

Practice address

11938 Paramount Blvd
Downey, CA 90242-2306

Phone

(562) 923-6060

Fax

(562) 923-6601

NPI assigned

Jul 24, 2023

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

Electronic endpoints 1

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

Specialty

Physician Assistant

Education

Other, 2022

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Southern California Permanente Medical Group

  • Health Maintenance Organization
  • Riverside, CA
  • NPI 1316979834
  Medicare reassignment
• Southern California Permanente Medical Group

  • Health Maintenance Organization
  • Baldwin Park, CA
  • NPI 1770515280
  Medicare reassignment
• Southern California Permanente Medical Group

  • Health Maintenance Organization
  • Santa Clarita, CA
  • NPI 1316409410
  NPD
• Southern California Permanente Medical Group

  • Health Maintenance Organization
  • Fontana, CA
  • NPI 1316463763
  NPD
• Southern California Permanente Medical Group

  • Health Maintenance Organization
  • Fullerton, CA
  • NPI 1336556059
  NPD
• Ame Medical Group Inc

  • Family Medicine Physician
  • Downey, CA
  • NPI 1861711863
  NPD (past)

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

{
    "created_epoch": "1690156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786060800000",
    "number": "1720768898",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11938 PARAMOUNT BLVD",
            "city": "DOWNEY",
            "state": "CA",
            "postal_code": "902422306",
            "telephone_number": "562-923-6060",
            "fax_number": "562-923-6601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11938 PARAMOUNT BLVD",
            "city": "DOWNEY",
            "state": "CA",
            "postal_code": "902422306",
            "telephone_number": "562-923-6060",
            "fax_number": "562-923-6601"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7521 Edinger Ave Unit 1612",
            "address_purpose": "LOCATION",
            "city": "Huntington Beach",
            "state": "CA",
            "postal_code": "926473585",
            "country_code": "US",
            "telephone_number": "952-217-0890",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8500 Florence Ave Ste 101",
            "address_purpose": "LOCATION",
            "city": "Downey",
            "state": "CA",
            "postal_code": "902404062",
            "country_code": "US",
            "telephone_number": "562-202-5020",
            "fax_number": "562-923-6601",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KOSTYUKEVICH",
        "first_name": "OKSANA",
        "middle_name": "LELYUKH",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-07-24",
        "last_updated": "2026-08-07",
        "certification_date": "2026-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": "PA63203",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "N",
            "endpointDescription": "Carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "7521 Edinger Ave Unit 1612",
            "city": "Huntington Beach",
            "state": "CA",
            "country_code": "US",
            "postal_code": "926473585",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Sienna Orange Koizumi
• Christopher Kolleff
• Philip Konopa
• Claire Jee Kook
• Ariel M Koster
• Kourosh K Shamlou MD Inc
• Marjorie Ann Krauss
• Colette Gabrielle Krilanovich
• Nageswari R Krishnareddy, MD
• Maya Tuyetmai Le Krug, PHARM.D.

• Physician Assistant in Downey, CA
• Providers in Downey, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 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.

Verify at the official NPI Registry.