Individual provider Active NPI

Nilufer Demirkan, PA-S

  • Student in an Organized Health Care Education/Training Program
  • Staten Island, NY
National Provider Identifier
1740876846
Registry record updated Dec 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
421 Jefferson Ave
Staten Island, NY 10306-5430
Phone
(347) 439-6480
NPI assigned
Dec 14, 2020
Last updated
Dec 14, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 14, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

421 Jefferson Ave
Staten Island, NY 10306-5430

Mailing address

421 Jefferson Ave
Staten Island, NY 10306-5430
Phone (347) 439-6480

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221209000478 NY Practitioner - Physician Assistant 0547639700 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Josiane Lederman, MD PCGroup PAC ID 3870483332, 6 clinicians

Practice addresses (Care Compare)

116 Lamberts LN
Staten Island, NY 10314-7210
Phone (718) 370-0422

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
029084NYMDPharmacist

Organizations & group practices 1

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": "1607904000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607904000000",
    "number": "1740876846",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "421 JEFFERSON AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103065430",
            "telephone_number": "347-439-6480"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "421 JEFFERSON AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103065430",
            "telephone_number": "347-439-6480"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEMIRKAN",
        "first_name": "NILUFER",
        "name_prefix": "Mrs.",
        "credential": "PA-S",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-12-14",
        "last_updated": "2020-12-14",
        "certification_date": "2020-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

Verify at the official NPI Registry.