Individual provider Active NPI

Nicholas T Nikolopoulos, DO

  • Family Medicine Physician
  • Warwick, RI
National Provider Identifier
1740591015
Registry record updated Aug 6, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
DO00744 Issued in RI
Practice address
300 Quaker LN # C2-4
Warwick, RI 02886-0159
Phone
(401) 233-5051
NPI assigned
Jul 1, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2020

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 LP02071 RI
Family Medicine Physician 207Q00000X 254757 MA
Family Medicine Physician 207Q00000X DO00744 RI Primary

Addresses

Primary practice location

300 Quaker LN # C2-4
Warwick, RI 02886-0159

Mailing address

30 W Monroe St Ste 1200
Chicago, IL 60603-2420
Phone (312) 733-9730

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in RI
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
I20130918000446 RI Practitioner - Family Practice 3779727516 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
254757MAMDFamily Medicine Physician
DO00744RIMDFamily Medicine Physician
LP02071RIMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Osh - Ri Physicians Group, PC Family Medicine CurrentSince Jun 1, 2020 Accepting new patients
Osh-Mi Physicians Group PC Family Medicine PastSince May 24, 2020 Accepting new patients

Locations

30 W Monroe St
Ste 1200
Chicago, IL 60603
Phone (773) 609-1758

300 Quaker Ln
#C24
Warwick, RI 02886
Phone (401) 233-5051

300 Quaker Ln
Warwick, RI 02886
Phone (401) 233-5051

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1277942400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1596672000000",
    "number": "1740591015",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 W MONROE ST STE 1200",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606032420",
            "telephone_number": "312-733-9730"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 QUAKER LN # C2-4",
            "city": "WARWICK",
            "state": "RI",
            "postal_code": "028860159",
            "telephone_number": "401-233-5051"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIKOLOPOULOS",
        "first_name": "NICHOLAS",
        "middle_name": "T",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-07-01",
        "last_updated": "2020-08-06",
        "certification_date": "2020-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "RI",
            "license": "LP02071",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MA",
            "license": "254757",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "RI",
            "license": "DO00744",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Warwick, RI

Sources for this page

Verify at the official NPI Registry.