Active NPI
Nikole Novikova
- Dentist
- Scottsdale, AZ
National Provider Identifier
1225440662
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- D011130
- Practice address
- 10005 E Osborn Rd BLDG 61
Scottsdale, AZ 85256-4019 - Phone
- (480) 946-9066
- NPI assigned
- May 20, 2014
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | CG60460804 | WA | |
| Dentist | 122300000X | D011130 | AZ | Primary |
Addresses
Primary practice location
10005 E Osborn Rd BLDG 61
Scottsdale, AZ 85256-4019
Mailing address
4628 S Centric Way
Mesa, AZ 85212-9417
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX, ME
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 2
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CG60460804 | WA | MD | Behavioral Analyst |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Salt River Pima-Maricopa Indian Community | Current | Accepting new patients | |
| Harrington Family Health Center | Current | Accepting new patients | |
| Salt River Pima-Maricopa Indian Community | Current | Accepting new patients | |
| Passamaquoddy Tribal Council | Past | Accepting new patients | |
| Salt River Pima-Maricopa Indian Community | Past | Accepting new patients | |
| Cbpi, LLC | Behavior Analyst | Past | Accepting new patients |
Locations
10005 E Osborn Rd
Bldg 61
Scottsdale, AZ 85256
Phone (480) 946-9103
10901 E McDowell Rd
Scottsdale, AZ 85256
Phone (480) 278-7742
50 E Main St
Harrington, ME 04643
Interoperability endpoints
- https://api.platform.athenahealth.com/10564/brand/1/csg/1/fhir/r4
Organizations & group practices 6
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.
-
- Community Health Clinic/Center
- Scottsdale, AZ
- NPI 1942668991
TX
-
- Federally Qualified Health Center (FQHC)
- Harrington, ME
- NPI 1255383972
-
- Community Health Clinic/Center
- Scottsdale, AZ
- NPI 1538583125
-
- Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy
- Scottsdale, AZ
- NPI 1790210755
-
- Behavior Analyst
- Kirkland, WA
- NPI 1215347752
-
- Federally Qualified Health Center (FQHC)
- Pleasant Point, ME
- NPI 1760474613
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1400544000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1629849600000",
"number": "1225440662",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4628 S CENTRIC WAY",
"city": "MESA",
"state": "AZ",
"postal_code": "852129417"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10005 E OSBORN RD BLDG 61",
"city": "SCOTTSDALE",
"state": "AZ",
"postal_code": "852564019",
"telephone_number": "480-946-9066"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NOVIKOVA",
"first_name": "NIKOLE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-05-20",
"last_updated": "2021-08-25",
"certification_date": "2021-08-25",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "WA",
"license": "CG60460804",
"primary": false
},
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "AZ",
"license": "D011130",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Scottsdale, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2021; 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.