Individual provider Active NPI

Estefania Romina Niewialkouski, DO

  • Pediatric Critical Care Medicine Physician
  • Fort Lauderdale, FL
National Provider Identifier
1699260018
Registry record updated May 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Critical Care Medicine PhysicianTaxonomy code 2080P0203X
License
OS17404 Issued in FL
Practice address
1600 S Andrews Ave
Ft Lauderdale, FL 33316-2510
Phone
(954) 459-2094
NPI assigned
Jun 27, 2018
Last updated
May 10, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 10, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X UO6227 FL
Pediatrics Physician 208000000X UO6227 FL
Pediatric Critical Care Medicine Physician 2080P0203X OS17404 FL Primary

Addresses

Primary practice location

1600 S Andrews Ave
Ft Lauderdale, FL 33316-2510

Mailing address

1600 S Andrews Ave
Ft Lauderdale, FL 33316-2510
Phone (954) 459-2094

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 Osteopathy

State licenses

LicenseStateTypeSpecialty
UO6227FLMDPediatrics Physician
OS17404FLMDPediatric Critical Care Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1530057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715299200000",
    "number": "1699260018",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 S ANDREWS AVE",
            "city": "FT LAUDERDALE",
            "state": "FL",
            "postal_code": "333162510",
            "telephone_number": "954-459-2094"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 S ANDREWS AVE",
            "city": "FT LAUDERDALE",
            "state": "FL",
            "postal_code": "333162510",
            "telephone_number": "954-459-2094"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIEWIALKOUSKI",
        "first_name": "ESTEFANIA",
        "middle_name": "ROMINA",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-27",
        "last_updated": "2024-05-10",
        "certification_date": "2024-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "FL",
            "license": "UO6227",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "UO6227",
            "primary": false
        },
        {
            "code": "2080P0203X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Critical Care Medicine",
            "state": "FL",
            "license": "OS17404",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Lauderdale, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2024; 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.