Alexandra Broustovetskaia, PH.D.
NPI 1124516026ActiveIndividual· Psychologist, Counseling· Raleigh, NC
Opted out of Medicare from October 2018 to October 2028. Psychologist, Counseling (PH.D.) in Raleigh, North Carolina, licensed in MA, with an NPI issued in April 2018.
Overview
| NPI | 1124516026 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | PH.D. |
| Sole proprietor | No |
| NPI issued | Apr 25, 2018 |
| Last updated in NPPES | Oct 2, 2018 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Psychologist, Counseling Primary | 103TC1900X | 10641 | MA |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Not in the public enrollment file of Oct 1, 2026 |
|---|---|
| Opt-out | Opted out Oct 2, 2018 – Oct 2, 2028 |
| Can order and refer | Yes |
During an opt-out period the provider sees Medicare patients only under private contracts, and Medicare does not pay claims for their services.
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