Individual provider Active NPI

Rahul Nikam, MBBS

  • Pediatric Radiology Physician
  • Orange, CA
National Provider Identifier
1700339504
Registry record updated Aug 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Radiology PhysicianTaxonomy code 2085P0229X
License
C1-0012542 Issued in DE
Practice address
1201 W la Veta Ave
Orange, CA 92868-4203
Phone
(888) 483-5670
Fax
(844) 890-2297
NPI assigned
Jul 27, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Neuroimaging (Radiology) Physician 2085D0003X MT210275 PA
Pediatric Radiology Physician 2085P0229X C195551 CA
Pediatric Radiology Physician 2085P0229X C1-0012542 DE Primary

Addresses

Primary practice location

1201 W la Veta Ave
Orange, CA 92868-4203

Mailing address

1201 W la Veta Ave
Orange, CA 92868-4203
Phone (888) 483-5670

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)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MT210275PAMDDiagnostic Neuroimaging (Radiology) Physician
C195551CAMDPediatric Radiology Physician

Interoperability endpoints

  • Direct secure messaging: rahul.nikam.1@9485.direct.athenahealth.com

NPI Registry JSON

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

{
    "created_epoch": "1469577600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724630400000",
    "number": "1700339504",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1201 W LA VETA AVE",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928684203",
            "telephone_number": "888-483-5670",
            "fax_number": "844-890-2297"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 W LA VETA AVE",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928684203",
            "telephone_number": "888-483-5670",
            "fax_number": "844-890-2297"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIKAM",
        "first_name": "RAHUL",
        "credential": "MBBS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-07-27",
        "last_updated": "2024-08-26",
        "certification_date": "2024-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085D0003X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Neuroimaging",
            "state": "PA",
            "license": "MT210275",
            "primary": false
        },
        {
            "code": "2085P0229X",
            "taxonomy_group": "",
            "desc": "Radiology, Pediatric Radiology",
            "state": "CA",
            "license": "C195551",
            "primary": false
        },
        {
            "code": "2085P0229X",
            "taxonomy_group": "",
            "desc": "Radiology, Pediatric Radiology",
            "state": "DE",
            "license": "C1-0012542",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orange, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 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.