Individual provider Active NPI

Khrystyna Splavnyk, PA

  • Medical Physician Assistant
  • Fort Lauderdale, FL
National Provider Identifier
1730598525
Registry record updated Dec 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA9112028 Issued in PA
Practice address
2021 E Commercial Blvd Ste 302
Fort Lauderdale, FL 33308-3754
Phone
(954) 463-6408
Fax
(954) 463-9208
NPI assigned
Aug 6, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 10, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA9112028 PA Primary

Addresses

Primary practice location

2021 E Commercial Blvd Ste 302
Fort Lauderdale, FL 33308-3754

Mailing address

1419 SE 8TH Ter Ste 200
Cape Coral, FL 33990-3213

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20241218000476 FL Practitioner - Physician Assistant 0941429336 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Genesiscare USA of Florida LLCGroup PAC ID 9830082882, 172 clinicians

Practice addresses (Care Compare)

1419 SE 8TH Ter
Cape Coral, FL 33990-3213
Phone (239) 772-3202

2150 S Andrews Ave
Suite 100
Fort Lauderdale, FL 33316-3432
Phone (954) 463-6408

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA9112028PAMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Genesiscare USA of Florida LLC CurrentSince Nov 4, 2024 Accepting new patients
Genesiscare USA of Florida LLC CurrentSince Nov 4, 2024 Accepting new patients
Genesiscare USA of Florida LLC Current Accepting new patients
Genesiscare USA of Florida LLC Past Accepting new patients

Locations

1419 SE 8th Ter
Ste 200
Cape Coral, FL 33990

1419 SE 8th Ter
Cape Coral, FL 33990
Phone (239) 772-3202

3680 Broadway
Fort Myers, FL 33901
Phone (239) 936-0380

2021 E Commercial Blvd
Ste 302
Ft Lauderdale, FL 33308
Phone (954) 463-6408

2150 S Andrews Ave
Ste 100
Ft Lauderdale, FL 33316
Phone (954) 463-6408

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: khrystynasplavnyk@fyc.medalliesdirect.net

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 and National Provider Directory roles.

Hospital & facility affiliations 5

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": "1407283200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733788800000",
    "number": "1730598525",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1419 SE 8TH TER STE 200",
            "city": "CAPE CORAL",
            "state": "FL",
            "postal_code": "339903213"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2021 E COMMERCIAL BLVD STE 302",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333083754",
            "telephone_number": "954-463-6408",
            "fax_number": "954-463-9208"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPLAVNYK",
        "first_name": "KHRYSTYNA",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-08-06",
        "last_updated": "2024-12-10",
        "certification_date": "2024-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "PA",
            "license": "PA9112028",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Lauderdale, FL

Sources for this page

Verify at the official NPI Registry.