Individual provider Active NPI

Ellen Nikolovienis

  • Speech-Language Pathologist
  • Douglaston, NY
National Provider Identifier
1588924583
Registry record updated May 23, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
Practice address
240-45 66TH Ave
Douglaston, NY 11362
Phone
(917) 560-0352
NPI assigned
May 23, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 23, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X Primary

Addresses

Primary practice location

240-45 66TH Ave
Douglaston, NY 11362

Mailing address

240-45 66TH Ave
Douglaston, NY 11362
Phone (917) 560-0352

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161108000237 NY Practitioner - Qualified Speech Language Pathologist 3779862198 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Global Speech Language Pathology PC Speech-Language Pathologist CurrentSince Sep 22, 2016 Accepting new patients
Epilepsy Foundation of L.I. CurrentSince Sep 22, 2016 Accepting new patients
Epic Medical Services PC CurrentSince Nov 19, 2016 Accepting new patients
Epic Long Island CurrentSince Sep 22, 2016 Accepting new patients

Locations

1500 Hempstead Tpke
East Meadow, NY 11554
Phone 51673977331420

1979 Marcus Ave
Ste 204
New Hyde Park, NY 11042
Phone (516) 327-4681

Organizations & group practices 4

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": "1337731200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1337731200000",
    "number": "1588924583",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "240-45 66TH AVE",
            "city": "DOUGLASTON",
            "state": "NY",
            "postal_code": "11362",
            "telephone_number": "917-560-0352"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "240-45 66TH AVE",
            "city": "DOUGLASTON",
            "state": "NY",
            "postal_code": "11362",
            "telephone_number": "917-560-0352"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIKOLOVIENIS",
        "first_name": "ELLEN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-05-23",
        "last_updated": "2012-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Douglaston, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.