Individual provider Active NPI

Edward Jikhars, RN

  • General Practice Registered Nurse
  • Hauppauge, NY
National Provider Identifier
1528638756
Registry record updated Jun 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice Registered NurseTaxonomy code 163WG0000X
License
474007 Issued in NY
Practice address
200 Wireless Blvd
Hauppauge, NY 11788-3974
Phone
(631) 853-6410
NPI assigned
Jun 29, 2021
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 29, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Registered Nurse 163WG0000X 474007 NY Primary

Addresses

Primary practice location

200 Wireless Blvd
Hauppauge, NY 11788-3974

Mailing address

745 10TH St
Islip Terrace, NY 11752-1706
Phone (207) 832-1936

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
474007NYMDGeneral Practice Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1624924800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624924800000",
    "number": "1528638756",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "745 10TH ST",
            "city": "ISLIP TERRACE",
            "state": "NY",
            "postal_code": "117521706",
            "telephone_number": "207-832-1936"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 WIRELESS BLVD",
            "city": "HAUPPAUGE",
            "state": "NY",
            "postal_code": "117883974",
            "telephone_number": "631-853-6410"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JIKHARS",
        "first_name": "EDWARD",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-06-29",
        "last_updated": "2021-06-29",
        "certification_date": "2021-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WG0000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, General Practice",
            "state": "NY",
            "license": "474007",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hauppauge, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.