Alisa Louise Niksch, MD

Primary specialty

Pediatric Cardiology PhysicianTaxonomy code 2080P0202X

License

243747 Issued in MA

Practice address

750 Washington St
The Floating Hospital for Children, #313
Boston, MA 02111-1526

Phone

(617) 636-5067

Fax

(617) 636-2354

NPI assigned

Oct 2, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in MA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: aniksch29888@tuftsmedicine.direct-ci.com

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.

• Pratt Pediatric Associates Inc

  • Pediatrics Physician
  • Boston, MA
  • NPI 1477590511
  Medicare reassignment
• Midwest Pediatric Cardiology, P.C.

  • Pediatric Cardiology Physician
  • Oak Lawn, IL
  • NPI 1962483669
  NPD (past)

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

{
    "created_epoch": "1159747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1297382400000",
    "number": "1336232255",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "750 WASHINGTON ST",
            "address_2": "THE FLOATING HOSPITAL FOR CHILDREN, #313",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021111526",
            "telephone_number": "617-636-5067",
            "fax_number": "617-636-2354"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "750 WASHINGTON ST",
            "address_2": "THE FLOATING HOSPITAL FOR CHILDREN, #313",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021111526",
            "telephone_number": "617-636-5067",
            "fax_number": "617-636-2354"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIKSCH",
        "first_name": "ALISA",
        "middle_name": "LOUISE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-02",
        "last_updated": "2011-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0202X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Cardiology",
            "state": "IL",
            "license": "036116468",
            "primary": false
        },
        {
            "code": "2080P0202X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Cardiology",
            "state": "MA",
            "license": "243747",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "243747",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036116468",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ivana Nikolic, MD
• Elena Nikolova, MD
• Moozhan Nikpanah, MD
• Nayer Nikpoor, M.D.
• Najmosama Nikrui, MD
• Karen M Nilan, R.N.
• Barbara L Niles, PHD
• John L Niles, MD
• Shalea Niles
• Eric James Nilles, MD

• Pediatric Cardiology Physician in Boston, MA
• Providers in Boston, MA by specialty
• Pediatric Cardiology Physician in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2011; 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.

Verify at the official NPI Registry.