Individual provider Active NPI

Albina V Reznichenko

  • Family Nurse Practitioner
  • Milton, WA
National Provider Identifier
1821864596
Registry record updated Dec 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP61495405 Issued in WA
Practice address
2748 Milton Way Ste 101
Milton, WA 98354-9379
Phone
(253) 922-5262
NPI assigned
Dec 4, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 4, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LF0000X AP61495405 WA Primary

Addresses

Primary practice location

2748 Milton Way Ste 101
Milton, WA 98354-9379

Mailing address

3518 Academy Dr SE
Auburn, WA 98092-7337
Phone (253) 632-4096

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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
I20240220003942 WA Practitioner - Nurse Practitioner 3971947763 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Franciscan Medical GroupGroup PAC ID 0547173866, 1,400 clinicians

Practice addresses (Care Compare)

2748 Milton Way
Suite 101
Milton, WA 98354-9379
Phone (253) 922-5262

Hospital & facility affiliations

  • St Joseph Medical Center Hospital, Tacoma, WA, CCN 500108
  • St Francis Community Hospital Hospital, Federal Way, WA, CCN 500141

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
AP61495405WAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Franciscan Medical Group Single Specialty Current Accepting new patients
Franciscan Medical Group Single Specialty CurrentSince Jan 29, 2024 Accepting new patients
Franciscan Medical Group Single Specialty CurrentSince Jan 29, 2024 Accepting new patients
Franciscan Medical Group Past Accepting new patients

Locations

2748 Milton Way
Ste 101
Milton, WA 98354
Phone (253) 922-5262

1812 S J St
Ste 120
Tacoma, WA 98405
Phone (253) 428-2200

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 6

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": "1701648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701648000000",
    "number": "1821864596",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3518 ACADEMY DR SE",
            "city": "AUBURN",
            "state": "WA",
            "postal_code": "980927337",
            "telephone_number": "253-632-4096"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2748 MILTON WAY STE 101",
            "city": "MILTON",
            "state": "WA",
            "postal_code": "983549379",
            "telephone_number": "253-922-5262"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REZNICHENKO",
        "first_name": "ALBINA",
        "middle_name": "V",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-12-04",
        "last_updated": "2023-12-04",
        "certification_date": "2023-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "WA",
            "license": "AP61495405",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Milton, WA

Sources for this page

Verify at the official NPI Registry.