Individual provider Active NPI

Zana Nikolla, M.D.

  • Gastroenterology Physician
  • Poughkeepsie, NY
National Provider Identifier
1881827368
Registry record updated Dec 28, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
253887 Issued in NY
Practice address
243 North Rd Ste 304
Poughkeepsie, NY 12601-1173
Phone
(845) 471-9410
Fax
(845) 451-7757
NPI assigned
Aug 31, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 28, 2018

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 253887 NY Primary

Addresses

Primary practice location

243 North Rd Ste 304
Poughkeepsie, NY 12601-1173

Mailing address

243 North Rd
Ste 304
Poughkeepsie, NY 12601-1173
Phone (845) 451-7251

Other identifiers 1

IdentifierTypeStateIssuer
03137024MedicaidNY

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
I20140416000269 NY Practitioner - Gastroenterology 0345472825 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

243 N Rd
Poughkeepsie, NY 12601-1173

696 Dutchess Tpke
Poughkeepsie, NY 12603-6444
Phone (845) 454-8200

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy143
Upper gastrointestinal (GI) endoscopy for acid reflux143

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
253887NYMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sun River Health Inc Current Accepting new patients
Premier Medical Group of the Hudson Valley, P.C. CurrentSince Mar 20, 2014 Accepting new patients
Premier Medical Group of the Hudson Valley P.C. Gastroenterology CurrentSince Mar 20, 2014 Accepting new patients
21 Reade Place ASC LLC Past Accepting new patients

Locations

3360 Route 343
Amenia, NY 12501
Phone (845) 373-9006

243 North Rd
Ste 304
Poughkeepsie, NY 12601
Phone (845) 451-7251

21 Reade Pl
Ste 3300
Poughkeepsie, NY 12601
Phone (845) 454-0222

Networks

  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H3359

Interoperability endpoints

  • Direct secure messaging: znikolla@premiermedicalhv.medentdirect.com

Organizations & group practices 4

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.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1251676800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1545955200000",
    "number": "1881827368",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "243 NORTH RD",
            "address_2": "STE 304",
            "city": "POUGHKEEPSIE",
            "state": "NY",
            "postal_code": "126011173",
            "telephone_number": "845-451-7251",
            "fax_number": "845-451-7757"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "243 NORTH RD STE 304",
            "city": "POUGHKEEPSIE",
            "state": "NY",
            "postal_code": "126011173",
            "telephone_number": "845-471-9410",
            "fax_number": "845-451-7757"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIKOLLA",
        "first_name": "ZANA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-08-31",
        "last_updated": "2018-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "NY",
            "license": "253887",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03137024",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Poughkeepsie, NY

Sources for this page

Verify at the official NPI Registry.