Active NPI
Nick G. Vatakis, M.D.
- Specialist
- New York, NY
National Provider Identifier
1285835637
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- 191863
- Practice address
- 150 E 69TH St
Suite 2H
New York, NY 10021-5704 - Phone
- (212) 249-6829
- Fax
- (212) 249-8546
- NPI assigned
- May 31, 2007
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Specialist | 174400000X | 191863 | NY | Primary |
Addresses
Primary practice location
150 E 69TH St
Suite 2H
New York, NY 10021-5704
Mailing address
150 E 69TH St
Suite 2H
New York, NY 10021-5704
Phone (212) 249-6829
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Dec 23, 2019 through Dec 23, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 191863 | NY | MD | Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1180569600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1285835637",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "150 E 69TH ST",
"address_2": "SUITE 2H",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100215704",
"telephone_number": "212-249-6829",
"fax_number": "212-249-8546"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "150 E 69TH ST",
"address_2": "SUITE 2H",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100215704",
"telephone_number": "212-249-6829",
"fax_number": "212-249-8546"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VATAKIS",
"first_name": "NICK",
"middle_name": "G.",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-05-31",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "NY",
"license": "191863",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in New York, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.