Individual provider Active NPI

Demetra Vasiliadis

  • Registered Nurse
  • Flushing, NY
National Provider Identifier
1184538803
Registry record updated Sep 30, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
979576 Issued in NY
Practice address
5645 Main St
Flushing, NY 11355-5045
Phone
(718) 670-2000
NPI assigned
Sep 30, 2026
Last updated
Sep 30, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 30, 2026

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 979576 NY Primary

Addresses

Primary practice location

5645 Main St
Flushing, NY 11355-5045

Mailing address

14314 14TH Ave
Whitestone, NY 11357-2331
Phone (718) 813-5913

Medicare participation

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

NPI Registry JSON

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

{
    "created_epoch": "1790726400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790726400000",
    "number": "1184538803",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14314 14TH AVE",
            "city": "WHITESTONE",
            "state": "NY",
            "postal_code": "113572331",
            "telephone_number": "718-813-5913"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5645 MAIN ST",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113555045",
            "telephone_number": "718-670-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VASILIADIS",
        "first_name": "DEMETRA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2026-09-30",
        "last_updated": "2026-09-30",
        "certification_date": "2026-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "979576",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Flushing, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.