Individual provider Active NPI

Nedim Hukovic, MD

  • Psychiatry Physician
  • Ogdensburg, NY
National Provider Identifier
1588687545
Registry record updated Sep 27, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
240508 Issued in NY
Practice address
1 Chimney Point Dr
Ogdensburg, NY 13669
Phone
(315) 394-0101
NPI assigned
Jul 25, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 240508 NY Primary

Addresses

Primary practice location

1 Chimney Point Dr
Ogdensburg, NY 13669

Mailing address

1 Chimney Point Dr
Ogdensburg, NY 13669-2212
Phone (315) 394-0101

Other practice location 1

214 King St
Ogdensburg, NY 13669-1142
Phone (315) 393-3600

Other practice location 2

732 Ford St
Ogdensburg, NY 13669-1704
Phone (315) 454-2542

Other identifiers 1

IdentifierTypeStateIssuer
06000001881MedicaidNY

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
I20160916001133 NY Order and Referring Only - PsychiatryPractitioner - Psychiatry 3375536816

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
001881NYMDBehavioral Analyst
240508NYMDPsychiatry Physician

NPI Registry JSON

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

{
    "created_epoch": "1153785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1538006400000",
    "number": "1588687545",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 CHIMNEY POINT DR",
            "city": "OGDENSBURG",
            "state": "NY",
            "postal_code": "136692212",
            "telephone_number": "315-394-0101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 CHIMNEY POINT DR",
            "city": "OGDENSBURG",
            "state": "NY",
            "postal_code": "13669",
            "telephone_number": "315-394-0101"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "214 King St",
            "address_purpose": "LOCATION",
            "city": "Ogdensburg",
            "state": "NY",
            "postal_code": "136691142",
            "country_code": "US",
            "telephone_number": "315-393-3600",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "732 Ford St",
            "address_purpose": "LOCATION",
            "city": "Ogdensburg",
            "state": "NY",
            "postal_code": "136691704",
            "country_code": "US",
            "telephone_number": "315-454-2542",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HUKOVIC",
        "first_name": "NEDIM",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-25",
        "last_updated": "2018-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NY",
            "license": "240508",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "06000001881",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ogdensburg, NY

Sources for this page

Verify at the official NPI Registry.