Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

MS. Alexandra Nicole Reivitis

Individual provider Physician Assistant · NPI 1407528771

MS. Alexandra Nicole Reivitis is a Physician Assistant in Santa Monica, California. Qualified in 2022, 4 years ago. Practices with Providence Saint Johns Medical Foundation, a 285-clinician group, works from 2 locations, accepts Medicare assignment and offers telehealth. Licensed in California.

Years since qualifying
4
Licensed in
CA
In the registry since
2021
Specialties on file
2
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Practice location Address checks out

901 Wilshire Blvd Fl 1
Santa Monica, CA 90401-1854
Phone: (310) 829-8945
Fax: (424) 212-5934
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 360 Huntington Ave, Boston, MA 02115-5000 — (617) 373-3195

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 61956 (CA)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1407528771
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedOctober 4, 2021
Last updated in NPPESOctober 22, 2025
Certification dateOctober 22, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2022 (4 years in practice)
Group practice Providence Saint Johns Medical Foundation — 285 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations3 on file with Medicare

Other providers in Santa Monica