Individual provider Active NPI

Nazokat Atadjanova

  • Psychiatric/Mental Health Nurse Practitioner
  • New York, NY
National Provider Identifier
1164063152
Registry record updated Nov 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
23254 Issued in SC
Practice address
109 W 27TH St RM 5S
New York, NY 10001-6208
Phone
(917) 634-5311
NPI assigned
Oct 1, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 23254 SC Primary

Addresses

Primary practice location

109 W 27TH St RM 5S
New York, NY 10001-6208

Mailing address

109 W 27TH St RM 5S
New York, NY 10001-6208
Phone (917) 634-5311

Other practice location 1

6500 University Ave Ste 200
Des Moines, IA 50324-1663
Phone (917) 634-5311

Other practice location 2

254 Commercial St Ste 245
Portland, ME 04101-4899
Phone (917) 634-5311

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260217000829 SC Practitioner - Nurse Practitioner 4688154834 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
MCCD FL Psychiatry Services PAGroup PAC ID 4880064070, 751 clinicians

Practice addresses (Care Compare)

900 Trail Ridge Rd
FL 1
Aiken, SC 29803-7765
Phone (833) 351-8255

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
23254SCMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
MCCD FL Psychiatry Services PA CurrentSince Jan 13, 2026 Accepting new patients

Locations

254 Commercial St
Ste 245
Portland, ME 04101
Phone (207) 716-5309

109 W 27th St
Rm 5S
New York, NY 10001
Phone (332) 230-4572

900 Trail Ridge Rd
Fl 1
Aiken, SC 29803
Phone (803) 233-2882

10 Hospital Center Cmns
Ste 400
Hilton Head Island, SC 29926

Organizations & group practices 1

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": "1569888000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762214400000",
    "number": "1164063152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "109 W 27TH ST RM 5S",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100016208",
            "telephone_number": "917-634-5311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "109 W 27TH ST RM 5S",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100016208",
            "telephone_number": "917-634-5311"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6500 University Ave Ste 200",
            "address_purpose": "LOCATION",
            "city": "Des Moines",
            "state": "IA",
            "postal_code": "503241663",
            "country_code": "US",
            "telephone_number": "917-634-5311",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "254 Commercial St Ste 245",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "ME",
            "postal_code": "041014899",
            "country_code": "US",
            "telephone_number": "917-634-5311",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ATADJANOVA",
        "first_name": "NAZOKAT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-10-01",
        "last_updated": "2025-11-04",
        "certification_date": "2025-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "SC",
            "license": "23254",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.