Individual provider Active NPI

Madina Akhmedova

  • Registered Nurse
  • Staten Island, NY
National Provider Identifier
1043944036
Registry record updated Jul 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
82476901 Issued in NY
Practice address
14 King James CT
Staten Island, NY 10308-2910
Phone
(347) 785-6533
NPI assigned
Jul 14, 2022
Last updated
Jul 14, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 82476901 NY Primary

Addresses

Primary practice location

14 King James CT
Staten Island, NY 10308-2910

Mailing address

14 King James CT
Staten Island, NY 10308-2910

Other identifiers 1

IdentifierTypeStateIssuer
82476901MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
82476901NYMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1657756800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657756800000",
    "number": "1043944036",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14 KING JAMES CT",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103082910"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14 KING JAMES CT",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103082910",
            "telephone_number": "347-785-6533"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AKHMEDOVA",
        "first_name": "MADINA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-07-14",
        "last_updated": "2022-07-14",
        "certification_date": "2022-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "82476901",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "82476901",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.