Nicolina Marie Wawrin, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

293684 Issued in NY

Practice address

2825 Jackson Ave FL 2
Long Island City, NY 11101-2920

Phone

(646) 962-4170

NPI assigned

Apr 18, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 3

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

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: nmw9003@direct.nyp.org

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.

• Weill Medical College of Cornell

  • Internal Medicine Physician
  • New York, NY
  • NPI 1124170212

  Pediatrics

  Medicare reassignment NPD
• Weill Medical College of Cornell

  • Cardiovascular Disease Physician
  • New York, NY
  • NPI 1144729385
  NPD
• Weill Medical College of Cornell

  • Internal Medicine Physician
  • New York, NY
  • NPI 1417990649
  NPD
• Cornell University Medical College

  • Psychologist
  • White Plains, NY
  • NPI 1528084910
  NPD (past)

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

{
    "created_epoch": "1429315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688860800000",
    "number": "1073900940",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2825 JACKSON AVE FL 2",
            "city": "LONG ISLAND CITY",
            "state": "NY",
            "postal_code": "111012920",
            "telephone_number": "646-962-4170"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2825 JACKSON AVE FL 2",
            "city": "LONG ISLAND CITY",
            "state": "NY",
            "postal_code": "111012920",
            "telephone_number": "646-962-4170"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "215 E 85th St",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100283108",
            "country_code": "US",
            "telephone_number": "646-962-7300",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WAWRIN",
        "first_name": "NICOLINA",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-04-18",
        "last_updated": "2023-07-09",
        "certification_date": "2023-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "293684",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "N",
            "endpointDescription": "FHIR",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "FHIR",
            "address_1": "2825 Jackson Ave Fl 2",
            "city": "Long Island City",
            "state": "NY",
            "country_code": "US",
            "postal_code": "111012920",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/R4/",
            "affiliation": "N",
            "endpointDescription": "FHIR",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "FHIR",
            "address_1": "2825 Jackson Ave Fl 2",
            "city": "Long Island City",
            "state": "NY",
            "country_code": "US",
            "postal_code": "111012920",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "nmw9003@direct.nyp.org",
            "affiliation": "N",
            "endpointDescription": "Direct Address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Direct Address",
            "address_1": "2825 Jackson Ave Fl 2",
            "city": "Long Island City",
            "state": "NY",
            "country_code": "US",
            "postal_code": "111012920",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Tariq Waseem, M.D.
• Karen Koziorzebska Watson
• Lori Watson, BSN
• Monique T Watson, RN
• Tyrone Watson, CASAC -2
• Brenna Weaver
• Lori Weber
• Weill Medical College of Cornell
• Daniel Douglas Weinstein, DDS
• Sarah M Weir

• Pediatrics Physician in Long Island City, NY
• Providers in Long Island City, NY by specialty
• Pediatrics Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2023; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.