NPIMap

Individual provider Active NPI

Alexander Elli Nuique Jr., MD

  • Family Medicine Physician
  • Williamsport, PA
National Provider Identifier
1023630480
Registry record updated Aug 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD482457 Issued in PA
Practice address
1205 River Avenue FL 2
Williamsport, PA 17701-4818
Phone
(570) 326-4118
Fax
(570) 326-5533
NPI assigned
May 8, 2020
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 22, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X MD482457 PA Primary

Addresses

Primary practice location

1205 River Avenue FL 2
Williamsport, PA 17701-4818

Mailing address

7 Dock Hill Road
Middleburg, PA 17845-8910
Phone (570) 837-2123

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address alexandernuiquemd@fpc.medentdirect.com Health Information Exchange (HIE) FAMILY PRACTICE CENTER, PC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230925000432 PA Practitioner - Family Practice 7416373220 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Family Practice Center PCGroup PAC ID 0244124212, 351 clinicians
H2 Rehabilitation Extension Services LLCGroup PAC ID 6406131622, shared by 5 NPIs, 161 clinicians
Phoenix Rehabilitation and Health Services IncGroup PAC ID 3476464298, shared by 2 NPIs, 2,775 clinicians

Practice addresses (Care Compare)

1205 River Ave
Suite 2
Williamsport, PA 17701-3724
Phone (570) 326-4118

1948 E 3Rd St
Suite C
Williamsport, PA 17701-3945
Phone (570) 327-1760

2000 Westinghouse Dr
Suite 200
Cranberry Township, PA 16066-5238

2733 State Route 45
Suite 6
Milton, PA 17847-8255
Phone (570) 955-3940

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal or shaving of skin growth1-10
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Family Practice Center, PC Multi-Specialty CurrentSince Sep 1, 2023 Accepting new patients
Family Practice Center, PC CurrentSince Sep 1, 2023 Accepting new patients

Locations

7 Dock Hill Rd
Middleburg, PA 17842
Phone (570) 837-2123

270 Susquehanna Valley Mall Dr
Ste 300
Selinsgrove, PA 17870
Phone (570) 743-1703

1205 River Ave
#2
Williamsport, PA 17701
Phone (570) 326-4118

1205 River Ave
#1
Williamsport, PA 17701
Phone (570) 323-5991

Interoperability endpoints

  • Direct secure messaging: alexandernuiquemd@fpc.medentdirect.com

Organizations & group practices 2

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.

Hospital & facility affiliations 39

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 39

NPI Registry JSON

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

{
    "created_epoch": "1588896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692662400000",
    "number": "1023630480",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7 DOCK HILL ROAD",
            "city": "MIDDLEBURG",
            "state": "PA",
            "postal_code": "178458910",
            "telephone_number": "570-837-2123",
            "fax_number": "570-837-2185"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1205 RIVER AVENUE FL 2",
            "city": "WILLIAMSPORT",
            "state": "PA",
            "postal_code": "177014818",
            "telephone_number": "570-326-4118",
            "fax_number": "570-326-5533"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NUIQUE",
        "first_name": "ALEXANDER",
        "middle_name": "ELLI",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-05-08",
        "last_updated": "2023-08-22",
        "certification_date": "2023-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "MD482457",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "alexandernuiquemd@fpc.medentdirect.com",
            "affiliation": "Y",
            "affiliationName": "FAMILY PRACTICE CENTER, PC",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "1205 RIVER AVENUE FL 2",
            "city": "WILLIAMSPORT",
            "state": "PA",
            "country_code": "US",
            "postal_code": "177014818",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Williamsport, PA

Sources for this page

Verify at the official NPI Registry.