Mykola Alexander Prisichenko

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA64439 Issued in CA

Practice address

25 Pacifica Apt 6408
Irvine, CA 92618-3367

Phone

(616) 581-8989

NPI assigned

Mar 20, 2024

Sex

Male

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 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, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Portola Medical Services PCGroup PAC ID 4789970773, 22 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: mykola.prisichenko.1@15000.direct.athenahealth.com

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.

• Portola Medical Services PC

  • Urgent Care Clinic/Center
  • Lake Forest, CA
  • NPI 1871962076
  Medicare reassignment Care Compare group
• Besa Health Yang P.C.

  • Multi-Specialty Clinic/Center
  • Santa Ana, CA
  • NPI 1336949254
  Medicare reassignment
• Oc Urgentcare Medical Group Incorporated

  • Urgent Care Clinic/Center
  • Anaheim, CA
  • NPI 1083940597
  Medicare reassignment
• Cypress Urgent Care, Inc

  • Urgent Care Clinic/Center
  • Cypress, CA
  • NPI 1881836989
  NPD (past)

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

{
    "created_epoch": "1710892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1771545600000",
    "number": "1982464624",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 PACIFICA APT 6408",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926183367",
            "telephone_number": "616-581-8989"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 PACIFICA APT 6408",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926183367",
            "telephone_number": "616-581-8989"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRISICHENKO",
        "first_name": "MYKOLA",
        "middle_name": "ALEXANDER",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-03-20",
        "last_updated": "2026-02-20",
        "certification_date": "2026-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA64439",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Primawellness Physical Therapy, Inc.
• Primecare Plus, Inc.
• Jacob W Prince
• Aira Samantha Ching Principe, LCSW
• Priority Medical Sales Inc
• Pristine Medical Management Inc
• Pro Health Psychiatry Nursing Corporation
• Procedure Center of Irvine Inc.
• Proedge Physical Therapy
• Professional Neuromonitoring Corporation

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 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.