Active NPI
Rahul Nikam, MBBS
- Pediatric Radiology Physician
- Orange, CA
National Provider Identifier
1700339504
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Radiology Physician
- License
- C1-0012542
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| License | State | Type | Specialty |
|---|---|---|---|
| MT210275 | PA | MD | Diagnostic Neuroimaging (Radiology) Physician |
| C195551 | CA | MD | Pediatric Radiology Physician |
Interoperability endpoints
- 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.