Active NPI
Nedim Hukovic, MD
- Psychiatry Physician
- Ogdensburg, NY
National Provider Identifier
1588687545
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 240508
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 06000001881 | Medicaid | NY |
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160916001133 | NY | Order and Referring Only - Psychiatry | 3375536816 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 001881 | NY | MD | Behavioral Analyst |
| 240508 | NY | MD | Psychiatry 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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.