Individual provider Active NPI

Nidhish Suresh, PHARM.D

  • Pharmacist
  • Bronx, NY
National Provider Identifier
1295049435
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
054889 Issued in NY
Practice address
5564 Broadway
Bronx, NY 10463-5216
Phone
(718) 548-5884
NPI assigned
Jul 29, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 054889 NY Primary

Addresses

Primary practice location

5564 Broadway
Bronx, NY 10463-5216

Mailing address

5564 Broadway
Bronx, NY 10463-5216
Phone (718) 548-5884

Other practice location 1

1134 East New York Ave
Brooklyn, NY 11212
Phone (718) 778-7901

Other practice location 2

1134 East New York Ave
Brooklyn, NY 11212
Phone (718) 778-7901

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
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
054889NYMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Walgreen Co Past Accepting new patients
Walgreen Co 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1280361600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1295049435",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5564 BROADWAY",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104635216",
            "telephone_number": "718-548-5884"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5564 BROADWAY",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104635216",
            "telephone_number": "718-548-5884"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1134 East New York Ave",
            "address_purpose": "LOCATION",
            "city": "Brooklyn",
            "state": "NY",
            "postal_code": "11212",
            "country_code": "US",
            "telephone_number": "718-778-7901",
            "fax_number": "718-778-7907",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1134 East New York Ave",
            "address_purpose": "LOCATION",
            "city": "Brooklyn",
            "state": "NY",
            "postal_code": "11212",
            "country_code": "US",
            "telephone_number": "718-778-7901",
            "fax_number": "718-778-7907",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SURESH",
        "first_name": "NIDHISH",
        "credential": "PHARM.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-07-29",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NY",
            "license": "054889",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.