Nicholas Panagiotis Roussis, MD

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

231555 Issued in NY

Practice address

1655 Richmond Ave
Ste E
Staten Island, NY 10314-1582

Phone

(718) 682-1900

Fax

(718) 682-1893

NPI assigned

Sep 9, 2005

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/EBJEAA

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.

• Soma Medical Services, P.C.

  • Dermatology Physician
  • Staten Island, NY
  • NPI 1720684087
  NPD Authorized official
• Amboy Medical Practice PC

  • Diagnostic Radiology Physician
  • Staten Island, NY
  • NPI 1104692672
  NPD (past)
• Amboy Medical Practice PC

  • Internal Medicine Physician
  • Staten Island, NY
  • NPI 1700037975

  Obstetrics & Gynecology

  NPD (past)
• Kinwell Medical Services, PC

  • Family Medicine Physician
  • Staten Island, NY
  • NPI 1447389630
  NPD (past)
• Richmond University Medical Center

  • Multi-Specialty Clinic/Center
  • Staten Island, NY
  • NPI 1811054042
  NPD (past)

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

{
    "created_epoch": "1126224000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630454400000",
    "number": "1497749089",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1655 RICHMOND AVE",
            "address_2": "STE E",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103141582",
            "telephone_number": "718-682-1900",
            "fax_number": "718-682-1893"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1655 RICHMOND AVE",
            "address_2": "STE E",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103141582",
            "telephone_number": "718-682-1900",
            "fax_number": "718-682-1893"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROUSSIS",
        "first_name": "NICHOLAS",
        "middle_name": "PANAGIOTIS",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-09-09",
        "last_updated": "2021-09-01",
        "certification_date": "2021-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NY",
            "license": "231555",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02526112",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• John Robert Rottkamp, MD
• Susan Roubicek, DMD
• Richard Rouder DPM
• Rouming Tots Inc
• George Panagiotis Roussis, MD
• Adam Routher, CRPA
• Mitchell Frank Rouzie, M.S.W.
• Tinamarie Rovito Gomez, PHD
• Germaine N Rowe, MD
• Holly Odianna Rowe, RN

• Obstetrics & Gynecology Physician in Staten Island, NY
• Providers in Staten Island, NY by specialty
• Obstetrics & Gynecology Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.