Alexis Nicheporuck, MD

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

MD491302 Issued in PA

Practice address

475 Seaview Ave
Staten Island, NY 10305-3436

Phone

(718) 226-8313

NPI assigned

Apr 27, 2020

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in PA

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

Specialty

Diagnostic Radiology

Education

Rutgers New Jersey Medical School, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Methodist Associates in Healthcare, IncGroup PAC ID 6406755651, 387 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Thomas Jefferson University Hospital Hospital, Philadelphia, PA, CCN 390174
• Jefferson Health- Northeast Hospital, Philadelphia, PA, CCN 390115

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Methodist Associates in Healthcare, Inc

  • Family Medicine Physician
  • Philadelphia, PA
  • NPI 1053355131

  Single Specialty

  Medicare reassignment Care Compare group NPD
• Progressive Physician Assoc Inc

  • Diagnostic Radiology Physician
  • Bethlehem, PA
  • NPI 1881646859
  Medicare reassignment
• Methodist Associates in Healthcare, Inc

  • Neurological Surgery Physician
  • Philadelphia, PA
  • NPI 1790390813

  Single Specialty

  NPD
• Methodist Associates in Healthcare, Inc.

  • Family Medicine Physician
  • Philadelphia, PA
  • NPI 1033575352
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Jefferson Health - Northeast

  • General Acute Care Hospital
  • Philadelphia, PA
  • NPI 1801963343
  Care Compare affiliation Name & address match
• Thomas Jefferson University Hospitals Inc

  • General Acute Care Hospital
  • Philadelphia, PA
  • NPI 1215916002
  Care Compare affiliation

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

{
    "created_epoch": "1587945600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757289600000",
    "number": "1336760784",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "66 RANDOLPH PL",
            "city": "WEST ORANGE",
            "state": "NJ",
            "postal_code": "070524853",
            "telephone_number": "973-900-1280"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "475 SEAVIEW AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103053436",
            "telephone_number": "718-226-8313"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICHEPORUCK",
        "first_name": "ALEXIS",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-04-27",
        "last_updated": "2025-09-08",
        "certification_date": "2025-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "PA",
            "license": "MD491302",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nhna PT PLLC
• Muhammad Rafay Khan Niazi, M.D
• Navya Nibu, RN
• Siny Nibu, LPN
• Ludivic Molina Nicanor, PT
• Nicholas P. Roussis, M.D., P.C.
• Irene Nicholas, MD
• Katelynn Nancy Nichols, MS., ED.
• Victoria Nichols, PH.D.
• Chelsea Nicholson, M.S

• Diagnostic Radiology Physician in Staten Island, NY
• Providers in Staten Island, NY by specialty
• Diagnostic Radiology Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2025; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.