Dmitri Nikolaenko, DO, MS

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

S0958 Issued in TX

Practice address

1004 W 32ND St Unit 400
Austin, TX 78705-1915

Phone

(512) 454-5171

Fax

(512) 454-0704

NPI assigned

Jun 8, 2012

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Internal Medicine

Education

Other, 2012

Medicare assignment

May accept Medicare assignment

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy, Master of Science

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: dmitri.nikolaenko.1@27378.direct.athenahealth.com
• FHIR API: https://api.platform.athenahealth.com/27378/brand/1/csg/1/fhir/r4

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.

• Ipc Healthcare Services of Texas, PLLC

  • Hospitalist Physician
  • San Antonio, TX
  • NPI 1023403011

  Internal Medicine

  Medicare reassignment NPD
• Lonestar Pat Associates PA

  • Hospitalist Physician
  • Round Rock, TX
  • NPI 1811594203

  Internal Medicine

  Medicare reassignment NPD
• St. David's Carenow Urgent Care PLLC

  • Family Medicine Physician
  • Austin, TX
  • NPI 1851844104
  NPD (past)

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

{
    "created_epoch": "1339113600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671408000000",
    "number": "1033471834",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1004 W 32ND ST UNIT 400",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787051915",
            "telephone_number": "512-454-5171",
            "fax_number": "512-454-0704"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1004 W 32ND ST UNIT 400",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787051915",
            "telephone_number": "512-454-5171",
            "fax_number": "512-454-0704"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIKOLAENKO",
        "first_name": "DMITRI",
        "name_prefix": "Dr.",
        "credential": "DO, MS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-06-08",
        "last_updated": "2022-12-19",
        "certification_date": "2022-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "S0958",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marie Jamille Niewiara, PT, DPT
• Natasha Niggles
• Erin Elizabeth Nightingale, FNP
• Kasey Nightingale
• Cullen Michael Nigrini, PT
• Gregory A. Nikolaidis
• Brandon Nila
• Abbey Nilson
• Jonathan C. Nilson, MD
• Nimbus Health Solutions (Lake Hills Pharmacy)

• Internal Medicine Physician in Austin, TX
• Providers in Austin, TX by specialty
• Internal Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.