Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

MS. ALEXIS MARIE POTHURAJU PA-C
NPI 1902630809
Physician Assistant in Winston Salem, NC

Q: What is Alexis Pothuraju's NPI number?

The NPI number for Alexis Pothuraju is 1902630809. It was assigned to this individual provider in the NPPES registry on September 2, 2024. The provider is also known as Alexis Marie Van Ryswyk PA.

Q: What is Alexis Pothuraju'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 Alexis Pothuraju was last updated on August 3, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 days 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 September 02, 2024PECOS Enrolled

3333 BROOKVIEW HILLS BLVD STE 204, WINSTON SALEM, NC 27103(336) 774-3740(336) 774-3780 Get Directions Write a Review

NPPES record last updated: August 3, 2026. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Aug 3, 2026, Sep 2, 2024 (2 updates tracked since 2024).

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About Ms. Alexis Marie Pothuraju Pa-c NPPES

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

MS. ALEXIS MARIE POTHURAJU PA-C (NPI 1902630809) is an individual physician assistant in Winston Salem, North Carolina, licensed in North Carolina (0010-14773) and active in the NPI registry since September 2024. She is enrolled in Medicare PECOS, is affiliated with Novant Health Forsyth Medical Center, and is a graduate of Other (2024).

NPPES Registry Identity

NPI1902630809

Entity TypeIndividualFemale

Primary Taxonomy363A00000X

Provider Legal NameMS. ALEXIS MARIE POTHURAJUCredential: PA-C

Location Address3333 BROOKVIEW HILLS BLVD STE 204Winston Salem, NC 27103-5661

Mailing AddressPo Box 751803Charlotte, NC 28275-1803 · (336) 774-3740 · Fax (336) 774-3780

Phone(336) 774-3740

Fax(336) 774-3780

Sole ProprietorNo

Medical School CMSOtherGraduated 2024

Enumeration DateSeptember 2, 2024

Last NPPES UpdateAugust 3, 20262 updates tracked since enumeration

NPPES CertifiedAugust 3, 2026

✔ NPI 1902630809 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363A00000X

License✔ Licensed in NC · 0010-14773

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.

3333 BROOKVIEW HILLS BLVD STE 204, Winston Salem, NC 27103

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Other Names 1

Former Name (1)Alexis Marie Van Ryswyk Pa

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of NC.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

Ms. Alexis Marie Pothuraju 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 ID7810421161

PECOS Enrollment IDI20241111000459

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.

Hospital Affiliations CMS Care Compare

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

Novant Health Forsyth Medical Center

Acute Care Hospitals · Winston-Salem, NC

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number340014

Location3333 Silas Creek ParkwayWinston-Salem, NC 27103 · Forsyth County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 27103 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

$83.90 typical visit price

range $54.12 – $165.09

Typical copayment $20.97 (range $13.53 – $41.27)

Most-billed visit code 99203

Established Patient

$67.72 typical visit price

range $17.21 – $134.61

Typical copayment $16.93 (range $4.30 – $33.65)

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.

Other Providers at the Same Location NPPES 6

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

STACEY JO EDWARDS FNP-C

Nurse Practitioner