Individual provider Active NPI

Nikolas Papaevagelou, M.D.

  • Pediatrics Physician
  • Astoria, NY
National Provider Identifier
1639332620
Registry record updated Jul 9, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
249236 Issued in NY
Practice address
22 47 Crescent Street
Suite101
Astoria, NY 11102
Phone
(718) 278-9500
NPI assigned
Jul 9, 2008
Last updated
Jul 9, 2008By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 9, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 249236 NY Primary

Addresses

Primary practice location

22 47 Crescent Street
Suite101
Astoria, NY 11102

Mailing address

22 47 Crescent Street
Suite101
Astoria, NY 11102
Phone (718) 278-9500

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
I20120405000179 NY Practitioner - Pediatric MedicinePractitioner - Emergency Medicine 5395906093 Reassigns benefits to 2 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
North Shore-Lij Medical PC CurrentSince Jan 10, 2022 Accepting new patients
Flushing Hospital & Medical Center CurrentSince Feb 27, 2012 Accepting new patients
Flushing Hospital Medical Center CurrentSince Feb 27, 2012 Accepting new patients
North Shore - Lij Medical PC CurrentSince Jan 10, 2022 Accepting new patients

Locations

2325 31st St
Astoria, NY 11105
Phone (516) 321-8315

2325 31st St
Fl 5
Astoria, NY 11105
Phone (718) 932-6300

14601 45th Ave
Flushing, NY 11355
Phone (718) 670-5562

4500 Parsons Blvd
Flushing, NY 11355
Phone (718) 670-5631

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

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359

Interoperability endpoints

  • Direct secure messaging: npapaevagelou15141@direct.medisys.org
  • Direct secure messaging: npapaevagelou67837@northwell.direct-ci.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1215561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1215561600000",
    "number": "1639332620",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22 47 CRESCENT STREET",
            "address_2": "SUITE101",
            "city": "ASTORIA",
            "state": "NY",
            "postal_code": "11102",
            "telephone_number": "718-278-9500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22 47 CRESCENT STREET",
            "address_2": "SUITE101",
            "city": "ASTORIA",
            "state": "NY",
            "postal_code": "11102",
            "telephone_number": "718-278-9500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAPAEVAGELOU",
        "first_name": "NIKOLAS",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-07-09",
        "last_updated": "2008-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "249236",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Astoria, NY

Sources for this page

Verify at the official NPI Registry.