Individual provider Active NPI

Nickie Niforatos Andescavage, MD

  • Neonatal-Perinatal Medicine Physician
  • Washington, DC
National Provider Identifier
1720245392
Registry record updated Jul 15, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neonatal-Perinatal Medicine PhysicianTaxonomy code 2080N0001X
License
MD037013 Issued in DC
Practice address
111 Michigan Ave NW
W3.5, 600
Washington, DC 20010-2916
Phone
(202) 476-3670
NPI assigned
May 20, 2008
Last updated
Jul 15, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2014

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
Pediatrics Physician 208000000X MD037013 DC
Neonatal-Perinatal Medicine Physician 2080N0001X MD037013 DC Primary

Addresses

Primary practice location

111 Michigan Ave NW
W3.5, 600
Washington, DC 20010-2916

Mailing address

111 Michigan Ave NW
W3.5, 600
Washington, DC 20010-2916
Phone (202) 476-3670

Other names 1

  • Dr. Nickie Niforatos Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC
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
I20111014000290 DC Practitioner - Pediatric MedicinePractitioner - Other (Physician) 6507038601 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD037013DCMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Children's Hospital CurrentSince Aug 1, 2012 Accepting new patients
Children's Hospital Pediatrics CurrentSince Aug 1, 2012 Accepting new patients
Children's Hospital Current Accepting new patients

Locations

111 Michigan Ave NW
Washington, DC 20010
Phone (202) 884-4177

111 Michigan Ave NW
#W35
Washington, DC 20010
Phone (202) 476-3670

900 23rd St NW
Washington, DC 20037
Phone (202) 715-4750

Organizations & group practices 3

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": "1211241600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1405382400000",
    "number": "1720245392",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 MICHIGAN AVE NW",
            "address_2": "W3.5, 600",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200102916",
            "telephone_number": "202-476-3670"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 MICHIGAN AVE NW",
            "address_2": "W3.5, 600",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200102916",
            "telephone_number": "202-476-3670"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDESCAVAGE",
        "first_name": "NICKIE",
        "middle_name": "NIFORATOS",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-05-20",
        "last_updated": "2014-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "DC",
            "license": "MD037013",
            "primary": false
        },
        {
            "code": "2080N0001X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": "DC",
            "license": "MD037013",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NICKIE",
            "last_name": "NIFORATOS",
            "prefix": "DR.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Washington, DC

Sources for this page

Verify at the official NPI Registry.