NPIMap

Individual provider Active NPI

Jawdat A Nikoula, M.D.

  • Family Medicine Physician
  • Irwin, PA
National Provider Identifier
1144228453
Registry record updated Aug 31, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD032696E Issued in PA
Practice address
905 Spruce St Ste 201
Irwin, PA 15642-3683
Phone
(724) 864-9595
Fax
(724) 864-9860
NPI assigned
Jul 11, 2005
Last updated
Aug 31, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD032696E PA Primary

Addresses

Primary practice location

905 Spruce St Ste 201
Irwin, PA 15642-3683

Mailing address

905 Spruce St
Suite 201
Irwin, PA 15642-3683
Phone (724) 864-9595

Other practice location 1

410 Pellis Rd Ste 1A
Greensburg, PA 15601-4700
Phone (724) 832-7877

Other identifiers 3

IdentifierTypeStateIssuer
CA3219OtherMEDICARE (RAILROAD)
0009874960001MedicaidPA
CA3219OtherMEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040721001088 PA Practitioner - Family Practice 2264338870 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1978
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Irwin Family Care, PCGroup PAC ID 9638083173, 9 clinicians

Practice addresses (Care Compare)

905 Spruce St
Suite 201
Irwin, PA 15642-3683
Phone (724) 864-9595

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD032696EPAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Irwin Family Care, PC Family Medicine CurrentSince Oct 7, 1985 Accepting new patients
Irwin Family Care, PC Family Medicine Current Accepting new patients
Redstone Presbyterian Senior Care Past Accepting new patients
Excela Health Physician Practices, Inc Past Accepting new patients

Locations

410 Pellis Rd
Greensburg, PA 15601
Phone (412) 565-7013

410 Pellis Rd
Ste 1A
Greensburg, PA 15601
Phone (724) 832-7877

905 Spruce St
North Huntingdon, PA 15642
Phone (724) 689-1335

905 Spruce St
Ste 201
North Huntingdon, PA 15642
Phone (724) 864-1115

Ownership & related parties

All facility ownership & control disclosures 3

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Upmc EastMonroeville, PA, CCN 39T328 Hospital Corporate Director Jul 1, 2020
Redstone HighlandsGreensburg, PA, CCN 396021 Skilled nursing facility Adp of the SNF Jul 9, 2025
Redstone @ HomeGreensburg, PA, CCN 398179 Home health agency Contracted Managing Employee Nov 1, 2023

Owned or controlled facilities with NPI records 3

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 25

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 25

NPI Registry JSON

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

{
    "created_epoch": "1121040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693440000000",
    "number": "1144228453",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "905 SPRUCE ST",
            "address_2": "SUITE 201",
            "city": "IRWIN",
            "state": "PA",
            "postal_code": "156423683",
            "telephone_number": "724-864-9595",
            "fax_number": "724-864-9860"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "905 SPRUCE ST STE 201",
            "city": "IRWIN",
            "state": "PA",
            "postal_code": "156423683",
            "telephone_number": "724-864-9595",
            "fax_number": "724-864-9860"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "410 Pellis Rd Ste 1A",
            "address_purpose": "LOCATION",
            "city": "Greensburg",
            "state": "PA",
            "postal_code": "156014700",
            "country_code": "US",
            "telephone_number": "724-832-7877",
            "fax_number": "724-832-7883",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NIKOULA",
        "first_name": "JAWDAT",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-11",
        "last_updated": "2023-08-31",
        "certification_date": "2023-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "MD032696E",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE (RAILROAD)",
            "identifier": "CA3219",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0009874960001",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "CA3219",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Irwin, PA

Sources for this page

Verify at the official NPI Registry.