Active NPI
Xystus B Nicome, PHARMACIST
- Pharmacist
- Brooklyn, NY
National Provider Identifier
1245412865
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 041572
- Practice address
- 750 New York Ave
Brooklyn, NY 11203-2028 - Phone
- (718) 941-8694
- NPI assigned
- Dec 5, 2007
- Last updated
- Dec 5, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 041572 | NY | Primary |
Addresses
Primary practice location
750 New York Ave
Brooklyn, NY 11203-2028
Mailing address
245 Clermont Ave
Brooklyn, NY 11205-4010
Phone (718) 930-7310
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 041572 | NY | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Duane Reade | Past | Accepting new patients | |
| Duane Reade | Past | Accepting new patients |
Organizations & group practices 2
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1196812800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1196812800000",
"number": "1245412865",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "245 CLERMONT AVE",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112054010",
"telephone_number": "718-930-7310"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "750 NEW YORK AVE",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112032028",
"telephone_number": "718-941-8694"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NICOME",
"first_name": "XYSTUS",
"middle_name": "B",
"credential": "PHARMACIST",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-12-05",
"last_updated": "2007-12-05",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NY",
"license": "041572",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Brooklyn, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.