Individual provider Active NPI

Benjamin Niknam, DO

  • Anesthesiology Physician
  • New Hyde Park, NY
National Provider Identifier
1588027767
Registry record updated Jul 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
303702 Issued in NY
Practice address
27005 76TH Ave
New Hyde Park, NY 11040-1402
Phone
(718) 470-5382
NPI assigned
Apr 4, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 303702 NY Primary

Addresses

Primary practice location

27005 76TH Ave
New Hyde Park, NY 11040-1402

Mailing address

27005 76TH Ave
New Hyde Park, NY 11040-1402
Phone (718) 470-5382

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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

Enrollment IDStateProvider typePAC IDDetails
I20200824002221 NY Practitioner - Anesthesiology 0345667267 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Ohio University, College of Osteopathic Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sedation Vacation Perioperative Medicine PLLCGroup PAC ID 1759658594, 86 clinicians
Centurion Brooklyn Anesthesia PLLCGroup PAC ID 0840519641, 7 clinicians
Randn Anesthesia PLLCGroup PAC ID 2062737794, 32 clinicians
New York UniversityGroup PAC ID 1355232422, 5,925 clinicians

Practice addresses (Care Compare)

1396 Myrtle Ave
Brooklyn, NY 11237-4513
Phone (718) 222-5999

1630 E 14TH St
Brooklyn, NY 11229-1104
Phone (646) 452-0802

480 Hicksville Rd
Bethpage, NY 11714-3415
Phone (718) 222-5999

530 1St Ave
New York, NY 10016-6402

550 1St Ave
New York, NY 10016-6402
Phone (212) 263-6037

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
303702NYMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sedation Vacation Perioperative Medicine PLLC CurrentSince May 14, 2022 Accepting new patients
Centurion Brooklyn Anesthesia PLLC CurrentSince Jun 1, 2025 Accepting new patients
North American Partners in Anesthesia LLP Anesthesiology CurrentSince May 19, 2020 Accepting new patients
New York University CurrentSince Oct 1, 2023 Accepting new patients
New York University Anesthesiology Current Accepting new patients
Centurion Midtown Anesthesia PLLC Anesthesiology CurrentSince Sep 1, 2024 Accepting new patients
New York University CurrentSince Oct 1, 2023 Accepting new patients

Locations

1396 Myrtle Ave
Brooklyn, NY 11237
Phone (718) 878-4313

1630 E 14th St
Brooklyn, NY 11229
Phone (516) 612-3722

10201 66th Rd
Forest Hills, NY 11375
Phone (718) 830-4091

68 S Service Rd
Ste 350
Melville, NY 11747
Phone (516) 945-3107

1510 Jericho Tpke
New Hyde Park, NY 11040
Phone (516) 216-5341

530 1st Ave
New York, NY 10016
Phone (212) 263-7216

27005 76th Ave
North New Hyde Pk, NY 11040

10512 101st Ave
Ozone Park, NY 11416
Phone (718) 847-3600

Organizations & group practices 8

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": "1459728000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626998400000",
    "number": "1588027767",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27005 76TH AVE",
            "city": "NEW HYDE PARK",
            "state": "NY",
            "postal_code": "110401402",
            "telephone_number": "718-470-5382"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27005 76TH AVE",
            "city": "NEW HYDE PARK",
            "state": "NY",
            "postal_code": "110401402",
            "telephone_number": "718-470-5382"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIKNAM",
        "first_name": "BENJAMIN",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-04-04",
        "last_updated": "2021-07-23",
        "certification_date": "2021-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NY",
            "license": "303702",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Hyde Park, NY

Sources for this page

Verify at the official NPI Registry.