Alexis A Hlavach, PA

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

PA9106648 Issued in FL

Practice address

8430 Cooper Creek Blvd Ste 102
University Park, FL 34201-2016

Phone

(941) 360-2255

Fax

(941) 487-1777

NPI assigned

Aug 13, 2012

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Specialty

Physician Assistant

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Premier Dermatology, LLCGroup PAC ID 6002031531, 48 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Networks

• Optimum HealthCare HMO Network
• Freedom Health HMO Network

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.

• Premier Dermatology, LLC

  • Dermatology Physician
  • Sarasota, FL
  • NPI 1700202298
  Medicare reassignment Care Compare group
• Schofield Hand and Bright Orthopaedics PLLC

  • Orthopaedic Surgery Physician
  • Sarasota, FL
  • NPI 1508082983
  Medicare reassignment

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

{
    "created_epoch": "1344816000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657152000000",
    "number": "1790032464",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8430 COOPER CREEK BLVD STE 102",
            "city": "UNIVERSITY PARK",
            "state": "FL",
            "postal_code": "342012016",
            "telephone_number": "941-360-2255",
            "fax_number": "941-487-1777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8430 COOPER CREEK BLVD STE 102",
            "city": "UNIVERSITY PARK",
            "state": "FL",
            "postal_code": "342012016",
            "telephone_number": "941-360-2255",
            "fax_number": "941-487-1777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HLAVACH",
        "first_name": "ALEXIS",
        "middle_name": "A",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-08-13",
        "last_updated": "2022-07-07",
        "certification_date": "2022-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": "FL",
            "license": "PA9106648",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Audra Hart
• Lillie Hauter, RBT
• Robert Jay Heller, MD
• Shelly Lynn Henry, MS, BCBA
• Angelica Hernandez
• Miracle Hobson
• Holiday CVS LLC
• Hopebridge LLC
• Hopebridge LLC
• Hopebridge LLC

• Dermatology Physician in University Park, FL
• Providers in University Park, FL by specialty
• Dermatology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2022; 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.