Active NPI
Lucas George Axiotakis Jr.
- Otolaryngology Physician
- New York, NY
National Provider Identifier
1043898265
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Otolaryngology Physician
- License
- 340390
- Practice address
- 222 E 41St St FL 8
New York, NY 10017-6739 - Phone
- (646) 754-1207
- NPI assigned
- Mar 30, 2021
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Otolaryngology Physician | 207Y00000X | 340390 | NY | Primary |
Addresses
Primary practice location
222 E 41St St FL 8
New York, NY 10017-6739
Mailing address
222 E 41St St FL 8
New York, NY 10017-6739
Phone (646) 754-1207
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20260615002754 | NY | Practitioner - Otolaryngology | 4981176567 |
Care Compare profile
Medicare Care Compare- Specialty
- Otolaryngology
- Education
- Other, 2021
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
70 Hicksville Rd
Suite 205
Bethpage, NY 11714-3411
700 Hicksville Rd
Bethpage, NY 11714-3471
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Interoperability endpoints
- laxiotakis31640@mskcc.direct-ci.com
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1617062400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1781654400000",
"number": "1043898265",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "222 E 41ST ST FL 8",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100176739",
"telephone_number": "646-754-1207"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "222 E 41ST ST FL 8",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100176739",
"telephone_number": "646-754-1207"
}
],
"practiceLocations": [],
"basic": {
"last_name": "AXIOTAKIS",
"first_name": "LUCAS",
"middle_name": "GEORGE",
"name_suffix": "Jr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-03-30",
"last_updated": "2026-06-17",
"certification_date": "2026-06-17",
"status": "A"
},
"taxonomies": [
{
"code": "207Y00000X",
"taxonomy_group": "",
"desc": "Otolaryngology",
"state": "NY",
"license": "340390",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in New York, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2026; 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.