Individual provider Active NPI

Alexandra Nickeson, BSN, RN-BC

  • Critical Care Medicine Registered Nurse
  • New York, NY
National Provider Identifier
1720430143
Registry record updated Jul 9, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Care Medicine Registered NurseTaxonomy code 163WC0200X
License
670348 Issued in NY
Practice address
525 E 68TH St
New York, NY 10065-4870
Phone
(832) 455-1154
NPI assigned
Jul 9, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Medicine Registered Nurse 163WC0200X 670348 NY Primary

Addresses

Primary practice location

525 E 68TH St
New York, NY 10065-4870

Mailing address

100 Paterson Plank Rd
#305
Jersey City, NJ 07307-1229
Phone (832) 455-1154

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
Bachelor on Science - Nursing

State licenses

LicenseStateTypeSpecialty
670348NYMDCritical Care Medicine Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1468022400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1468022400000",
    "number": "1720430143",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 PATERSON PLANK RD",
            "address_2": "#305",
            "city": "JERSEY CITY",
            "state": "NJ",
            "postal_code": "073071229",
            "telephone_number": "832-455-1154"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "525 E 68TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100654870",
            "telephone_number": "832-455-1154"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICKESON",
        "first_name": "ALEXANDRA",
        "credential": "BSN, RN-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-07-09",
        "last_updated": "2016-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WC0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Critical Care Medicine",
            "state": "NY",
            "license": "670348",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2016; 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.