Individual provider Active NPI

Donald M Nicolardi, MD

  • Gastroenterology Physician
  • Forest Hills, NY
National Provider Identifier
1841239159
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
158848 Issued in NY
Practice address
9610 Metropolitan Ave
Forest Hills, NY 11375-6625
Phone
(718) 459-0400
Fax
(718) 286-3863
NPI assigned
Jun 5, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X 158848 NY Primary

Addresses

Primary practice location

9610 Metropolitan Ave
Forest Hills, NY 11375-6625

Mailing address

30 Joyce LN
Woodbury, NY 11797-2114
Phone (516) 384-8840

Other identifiers 1

IdentifierTypeStateIssuer
01010080MedicaidNY

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210127001638 NY Order and Referring Only - Internal MedicinePractitioner - Internal Medicine 8123039864

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
158848NYMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Queens Long Island Medical Group, P.C. Past Accepting new patients
Qlimg Rochdale Village OB/GYN Office Past Accepting new patients

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": "1149465600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1841239159",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 JOYCE LN",
            "city": "WOODBURY",
            "state": "NY",
            "postal_code": "117972114",
            "telephone_number": "516-384-8840",
            "fax_number": "561-921-2577"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9610 METROPOLITAN AVE",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113756625",
            "telephone_number": "718-459-0400",
            "fax_number": "718-286-3863"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICOLARDI",
        "first_name": "DONALD",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-05",
        "last_updated": "2026-07-13",
        "certification_date": "2021-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "NY",
            "license": "158848",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01010080",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Forest Hills, NY

Sources for this page

Verify at the official NPI Registry.