Individual provider Active NPI

Nikole Grace Hedges, PA

  • Physician Assistant
  • Bronx, NY
National Provider Identifier
1497954762
Registry record updated Feb 20, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
6005 Issued in GA
Practice address
234 E 149TH St
Bronx, NY 10451-5504
Phone
(718) 579-5707
NPI assigned
Jul 16, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 6005 GA Primary

Addresses

Primary practice location

234 E 149TH St
Bronx, NY 10451-5504

Mailing address

5665 New Northside Dr NW Ste 320
Atlanta, GA 30328-5834
Phone (770) 874-5400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA, NE2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20101209000376 GA Practitioner - Physician Assistant 0547353302 Reassigns benefits to 2 organizations
I20210907001079 NE Practitioner - Physician Assistant 0547353302 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Unmc PhysiciansGroup PAC ID 6002728391, 1,490 clinicians

Practice addresses (Care Compare)

987400 Nebraska Medical Ctr
Unmc Physicians Nebraska Medical Center
Omaha, NE 68198-7400
Phone (402) 559-4000

Emile 42ND St
Omaha, NE 68198-0001
Phone (402) 559-4015

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
011922NYMDMental Health Counselor
6005GAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
New Century Physicians of Nebraska LLC CurrentSince Sep 1, 2021 Accepting new patients
Haysam Akkad, MD, PC Physician Assistant Past Accepting new patients

Locations

16901 Lakeside Hills Ct
Omaha, NE 68130
Phone (402) 572-6500

Interoperability endpoints

  • Direct secure messaging: nhedges360489@direct.nebraskamed.com

Organizations & group practices 5

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": "1184544000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1329696000000",
    "number": "1497954762",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5665 NEW NORTHSIDE DR NW STE 320",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303285834",
            "telephone_number": "770-874-5400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "234 E 149TH ST",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104515504",
            "telephone_number": "718-579-5707"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEDGES",
        "first_name": "NIKOLE",
        "middle_name": "GRACE",
        "name_prefix": "Miss",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-16",
        "last_updated": "2012-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "6005",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.