Individual provider Active NPI

Yaghoub Nikon, MD

  • Pulmonary Disease Physician
  • York, PA
National Provider Identifier
1063995694
Registry record updated Dec 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
TMD004939 Issued in PA
Practice address
1703 Innovation Dr Ste 4120
York, PA 17408-8815
Phone
(717) 632-9263
Fax
(717) 646-7439
NPI assigned
Sep 10, 2018
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 22, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pulmonary Disease Physician 207RP1001X TMD004939 PA Primary
Pulmonary Disease PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RP1001X 0101236054 VA

Addresses

Primary practice location

1703 Innovation Dr Ste 4120
York, PA 17408-8815

Mailing address

1703 Innovation Dr Ste 4120
York, PA 17408-8815

Other practice location 1

625 Davis Dr.
Newmarket, ON L3Y 2X2
CA
Phone (905) 954-1555

Other identifiers 1

IdentifierTypeStateIssuer
103810633MedicaidPA

Other names 1

  • Dr. Yaghoub Nikahn Other name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address ynikon175247@phsdirect.pinnaclehealth.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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

Enrollment IDStateProvider typePAC IDDetails
I20200820003485 PA Practitioner - Internal Medicine 4385060367 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
86.08 of 100Reported as group
Quality
76.48
Promoting interoperability
100
Improvement activities
40
Cost
77.12

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
TMD004939PAMDPulmonary Disease Physician
0101236054VAMDPulmonary Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pinnacle Health Medical Services CurrentSince Jul 8, 2020 Accepting new patients
Pinnacle Health Medical Services Single Specialty Current Accepting new patients
Pinnacle Health Medical Services Single Specialty CurrentSince Jul 8, 2020 Accepting new patients

Locations

2501 N 3rd St
Fl 2
Harrisburg, PA 17110
Phone (717) 782-2100

409 S 2nd St
Ste 2F
Harrisburg, PA 17104
Phone (717) 231-8049

1703 Innovation Dr
Ste 4120
York, PA 17408
Phone (717) 632-9263

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1536537600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1608595200000",
    "number": "1063995694",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1703 INNOVATION DR STE 4120",
            "city": "YORK",
            "state": "PA",
            "postal_code": "174088815"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1703 INNOVATION DR STE 4120",
            "city": "YORK",
            "state": "PA",
            "postal_code": "174088815",
            "telephone_number": "717-632-9263",
            "fax_number": "717-646-7439"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "625 Davis Dr.",
            "address_purpose": "LOCATION",
            "city": "Newmarket",
            "state": "ON",
            "postal_code": "L3Y 2X2",
            "country_code": "CA",
            "telephone_number": "905-954-1555",
            "fax_number": "905-954-1506",
            "country_name": "Canada",
            "address_type": "FGN"
        }
    ],
    "basic": {
        "last_name": "NIKON",
        "first_name": "YAGHOUB",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-09-10",
        "last_updated": "2020-12-22",
        "certification_date": "2020-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "PA",
            "license": "TMD004939",
            "primary": true
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "VA",
            "license": "0101236054",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "103810633",
            "state": "PA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ynikon175247@phsdirect.pinnaclehealth.org",
            "affiliation": "N",
            "address_1": "1703 Innovation Dr Ste 4120",
            "city": "York",
            "state": "PA",
            "country_code": "US",
            "postal_code": "174088815",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "YAGHOUB",
            "last_name": "NIKAHN",
            "prefix": "DR.",
            "credential": "MD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in York, PA

Sources for this page

Verify at the official NPI Registry.