Active NPI
Nicholas Stroumbakis, PA-C
- Surgical Physician Assistant
- Derby, CT
National Provider Identifier
1871002147
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgical Physician Assistant
- License
- 4027
- Practice address
- 130 Division St
Derby, CT 06418-1326 - Phone
- (203) 732-1330
- Fax
- (203) 732-1332
- NPI assigned
- Sep 29, 2017
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgical Physician Assistant | 363AS0400X | 4027 | CT | Primary |
Addresses
Primary practice location
130 Division St
Derby, CT 06418-1326
Mailing address
67 Maple Ave
Derby, CT 06418-1328
Other practice location 1
6 Greenwich Office Park
Greenwich, CT 06831-5151
Phone (203) 869-1145 ext. 279
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY, CT
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 2
Care Compare profile
Medicare Care CompareMerit-based Incentive Payment System (MIPS)
- Final score
- 0 of 100
- Quality
- 0
- Promoting interoperability
- 0
- Improvement activities
- 0
- Cost
- 0
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4027 | CT | MD | Surgical Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| North Shore - Lij Medical PC | Current | Accepting new patients |
Locations
300 Community Dr
Plandome, NY 11030
755 N Broadway
Sleepy Hollow, NY 10591
Phone (914) 302-0100
Organizations & group practices 3
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.
-
- Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
- Derby, CT
- NPI 1598755605
-
- Urology Physician
- Great Neck, NY
- NPI 1053688572
-
- Internal Medicine Physician
- New Hyde Park, NY
- NPI 1790043479
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1506643200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1768176000000",
"number": "1871002147",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "67 MAPLE AVE",
"city": "DERBY",
"state": "CT",
"postal_code": "064181328"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "130 DIVISION ST",
"city": "DERBY",
"state": "CT",
"postal_code": "064181326",
"telephone_number": "203-732-1330",
"fax_number": "203-732-1332"
}
],
"practiceLocations": [
{
"address_1": "6 Greenwich Office Park",
"address_purpose": "LOCATION",
"city": "Greenwich",
"state": "CT",
"postal_code": "068315151",
"country_code": "US",
"telephone_number": "203-869-1145 x279",
"fax_number": "203-618-1721",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "STROUMBAKIS",
"first_name": "NICHOLAS",
"name_prefix": "Mr.",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-09-29",
"last_updated": "2026-01-12",
"certification_date": "2026-01-12",
"status": "A"
},
"taxonomies": [
{
"code": "363AS0400X",
"taxonomy_group": "",
"desc": "Physician Assistant, Surgical",
"state": "CT",
"license": "4027",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Derby, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2026; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.