Active NPI
Nicholas Alex Athanasiou, M.D.
- Psychiatry Physician
- Bakersfield, CA
National Provider Identifier
1801059860
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- A110558
- Practice address
- 1700 Mount Vernon Ave
RM # 3057
Bakersfield, CA 93306-4018 - Phone
- (661) 326-2253
- NPI assigned
- Jul 9, 2008
- Last updated
- Sep 24, 2013
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction Medicine (Psychiatry & Neurology) Physician | 2084A0401X | A110558 | CA | |
| Psychiatry Physician | 2084P0800X | A110558 | CA | Primary |
Addresses
Primary practice location
1700 Mount Vernon Ave
RM # 3057
Bakersfield, CA 93306-4018
Mailing address
1700 Mount Vernon Ave
RM # 3057
Bakersfield, CA 93306-4018
Phone (661) 326-2253
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
- Opted out of Medicare
- Yes, effective Apr 26, 2018 through Apr 26, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 110558 | CA | MD | Marriage & Family Therapist |
| A110558 | CA | MD | Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1215561600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1379980800000",
"number": "1801059860",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1700 MOUNT VERNON AVE",
"address_2": "RM # 3057",
"city": "BAKERSFIELD",
"state": "CA",
"postal_code": "933064018",
"telephone_number": "661-326-2253"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1700 MOUNT VERNON AVE",
"address_2": "RM # 3057",
"city": "BAKERSFIELD",
"state": "CA",
"postal_code": "933064018",
"telephone_number": "661-326-2253"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ATHANASIOU",
"first_name": "NICHOLAS",
"middle_name": "ALEX",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2008-07-09",
"last_updated": "2013-09-24",
"status": "A"
},
"taxonomies": [
{
"code": "2084A0401X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Addiction Medicine",
"state": "CA",
"license": "A110558",
"primary": false
},
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "CA",
"license": "A110558",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bakersfield, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.