Alexandra Ruthann Tucker, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

4914 Issued in SC

Practice address

1202 E Butler Rd
Greenville, SC 29607-5910

Phone

(864) 627-3800

NPI assigned

Sep 13, 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

Other names 1

• Miss Alexandra Ruthann Busto Former name

Medicare fee-for-service enrollment

Enrolled in SC

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, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Allergic Disease and Asthma Center PAGroup PAC ID 7113992660, 7 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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.

• Allergic Disease and Asthma Center PA

  • Allergy Physician
  • Greenville, SC
  • NPI 1952302853
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1694563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697587200000",
    "number": "1750168530",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "233 LIGHTBOURNE DR APT 3F",
            "city": "SPARTANBURG",
            "state": "SC",
            "postal_code": "293015396",
            "telephone_number": "803-719-6314"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1202 E BUTLER RD",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296075910",
            "telephone_number": "864-627-3800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TUCKER",
        "first_name": "ALEXANDRA",
        "middle_name": "RUTHANN",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-09-13",
        "last_updated": "2023-10-18",
        "certification_date": "2023-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "SC",
            "license": "4914",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ALEXANDRA",
            "last_name": "BUSTO",
            "middle_name": "RUTHANN",
            "prefix": "MISS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Carsyn Butler Truitt, MSP, CCC-SLP
• Teresa Danielle Truman, APRN
• Willy Cheng Tsai, M.D.
• Song-Yih Tu, M.D.
• Christina Lynn Tucci, OT
• Allison Elizabeth Tucker, PA
• Ashley Latiff Tucker
• Caitlan Walsh Tucker, PA
• Carly Tucker, M.S. OTR/L
• Holly Lynn Tucker, MSW

• Physician Assistant in Greenville, SC
• Providers in Greenville, SC by specialty
• Physician Assistant in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2023; 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.