Individual provider Active NPI

Alexander Matsikas, PHARM.D

  • Pharmacist
  • Flushing, NY
National Provider Identifier
1669654703
Registry record updated Oct 13, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
051959 Issued in NY
Practice address
16103 29TH Ave
Flushing, NY 11358-1049
Phone
(718) 767-2400
NPI assigned
Nov 30, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 13, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 051959 NY Primary

Addresses

Primary practice location

16103 29TH Ave
Flushing, NY 11358-1049

Mailing address

178 New Hyde Park Rd
Franklin Square, NY 11010-3012
Phone (516) 775-4294

Other identifiers 1

IdentifierTypeStateIssuer
00703324MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
051959NYMDOrthodontics and Dentofacial Orthopedic Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Atlantic Consultants LLC CurrentSince Oct 19, 2020 Accepting new patients
Pelham City Pharmacy Inc Current Accepting new patients
Nitin Mariwalla MD PLLC Current Accepting new patients
Bowne Chemists LLC. PastSince Oct 19, 2020 Accepting new patients

Locations

16103 29th Ave
Flushing, NY 11358
Phone (718) 767-2400

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": "1196380800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602547200000",
    "number": "1669654703",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "178 NEW HYDE PARK RD",
            "city": "FRANKLIN SQUARE",
            "state": "NY",
            "postal_code": "110103012",
            "telephone_number": "516-775-4294"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16103 29TH AVE",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113581049",
            "telephone_number": "718-767-2400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATSIKAS",
        "first_name": "ALEXANDER",
        "credential": "PHARM.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-11-30",
        "last_updated": "2020-10-13",
        "certification_date": "2020-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NY",
            "license": "051959",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00703324",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Flushing, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.