ALEXANDRA NICOLE MYCOCK PA-C
NPI 1679288534
Physician Assistant in Greenville, SC

Q: What is Alexandra Mycock's NPI number?

The NPI number for Alexandra Mycock is 1679288534. It was assigned to this individual provider in the NPPES registry on January 16, 2023.

Q: What is Alexandra Mycock's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Q: When was this NPI record last updated?

The NPPES record for Alexandra Mycock was last updated on January 14, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since January 16, 2023PECOS EnrolledAccepts Medicare Assignment

890 W FARIS RD STE 100, GREENVILLE, SC 29605(864) 455-2888(864) 455-2885 Get Directions Write a Review

NPPES record last updated: January 14, 2026. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Jan 14, 2026, Jan 16, 2023 (2 updates tracked since 2023).

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About Alexandra Nicole Mycock Pa-c NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ALEXANDRA NICOLE MYCOCK PA-C (NPI 1679288534) is an individual physician assistant in Greenville, South Carolina, licensed in South Carolina (4805) and active in the NPI registry since January 2023. She is enrolled in Medicare PECOS, is affiliated with Prisma Health Greenville Memorial Hospital, and is a graduate of Other (2022).

NPPES Registry Identity

NPI1679288534

Entity TypeIndividualFemale

Primary Taxonomy363A00000X

Provider Legal NameALEXANDRA NICOLE MYCOCKCredential: PA-C

Location Address890 W FARIS RD STE 100Greenville, SC 29605-4285

Mailing Address300 E Mcbee Ave Fl 4Greenville, SC 29601-2842 · (864) 522-2603 · Fax (864) 455-2885

Phone(864) 455-2888

Fax(864) 455-2885

Sole ProprietorNo

Medical School CMSOtherGraduated 2022

Enumeration DateJanuary 16, 2023

Last NPPES UpdateJanuary 14, 20262 updates tracked since enumeration

NPPES CertifiedJanuary 14, 2026

✔ NPI 1679288534 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363A00000X

License✔ Licensed in SC · 4805

Definition

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

Also ListedPhysician Assistant · MedicalTaxonomy 363AM0700X · License PA4805 (SC)

890 W FARIS RD STE 100, Greenville, SC 29605

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include BlueCross BlueShield of South Carolina, First Choice Next.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Alexandra Nicole Mycock Pa-c is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID2163878869

PECOS Enrollment IDI20231101002419

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 2

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

57 services45 patients

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

40 services34 patients

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Prisma Health Greenville Memorial Hospital

Acute Care Hospitals · Greenville, SC

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number420078

Location701 Grove RoadGreenville, SC 29605 · Greenville County

Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 29605 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$83.18 typical visit price

range $53.57 – $163.84

Typical copayment $20.79 (range $13.39 – $40.96)

Most-billed visit code 99203

Established Patient

$67.12 typical visit price

range $16.96 – $133.52

Typical copayment $16.78 (range $4.24 – $33.38)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. ANDRE C EADDY M.D., PH.D.

Internal Medicine (Gastroenterology)