Active NPI
Redi Nikollari, MD
- Student in an Organized Health Care Education/Training Program
- Bronx, NY
National Provider Identifier
1295412385
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Student in an Organized Health Care Education/Training Program
- Practice address
- 4422 3Rd Ave
Bronx, NY 10457-2594 - Phone
- (718) 960-9000
- NPI assigned
- Jun 29, 2023
- 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 |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | Primary |
Addresses
Primary practice location
4422 3Rd Ave
Bronx, NY 10457-2594
Mailing address
6401 Boulevard E Apt C3
West New York, NJ 07093-4122
Phone (646) 693-2460
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in LA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20260601003745 | LA | Order and Referring Only - Cardiovascular Disease (Cardiology) | 8022588912 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Interoperability endpoints
- redi.nikollari.1@18107.direct.athenahealth.com
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1687996800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1687996800000",
"number": "1295412385",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6401 BOULEVARD E APT C3",
"city": "WEST NEW YORK",
"state": "NJ",
"postal_code": "070934122",
"telephone_number": "646-693-2460"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4422 3RD AVE",
"city": "BRONX",
"state": "NY",
"postal_code": "104572594",
"telephone_number": "718-960-9000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NIKOLLARI",
"first_name": "REDI",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2023-06-29",
"last_updated": "2023-06-29",
"certification_date": "2023-06-29",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"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 Jun 29, 2023; 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.