Individual provider Active NPI

Elena Nikou Theodosiou, MD

  • Hematology & Oncology Physician
  • Portsmouth, NH
National Provider Identifier
1891730982
Registry record updated Jun 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
License
16333 Issued in NH
Practice address
155 Borthwick Ave
Suite 301
Portsmouth, NH 03801-7156
Phone
(603) 433-5226
Fax
(603) 433-4939
NPI assigned
Jun 20, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology & Oncology Physician 207RH0003X 016524 ME
Hematology & Oncology Physician 207RH0003X 290174 NY
Hematology & Oncology Physician 207RH0003X 16333 NH Primary

Addresses

Primary practice location

155 Borthwick Ave
Suite 301
Portsmouth, NH 03801-7156

Mailing address

155 Borthwick Ave
Suite 301
Portsmouth, NH 03801-7156
Phone (603) 433-5226

Other practice location 1

1300 Massachusetts Avenue
Hildegard Medicus Cancer Center
Troy, NY 12180-1628
Phone (518) 268-5060

Other identifiers 1

IdentifierTypeStateIssuer
3092047MedicaidNH

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address payer.credentialing@sphp.com Direct

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
I20170913001180 NY Practitioner - Medical Oncology 5092788216 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Medical Oncology
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

317 S Manning Blvd
Suite 220
Albany, NY 12208-3909
Phone (518) 525-6418

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
016524MEMDHematology & Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Samaritan Hospital of Troy, New York Hematology & Oncology CurrentSince Jan 1, 2019 Accepting new patients
St. Peter'S Hospital of the City of Albany CurrentSince Sep 25, 2017 Accepting new patients
St. Peter'S Hospital of the City of Albany CurrentSince Sep 25, 2017 Accepting new patients
St. Peter'S Health Partners Medical Associates, P.C. CurrentSince Sep 25, 2017 Accepting new patients

Locations

315 S Manning Blvd
Albany, NY 12208
Phone (518) 525-1852

317 S Manning Blvd
Ste 100
Albany, NY 12208
Phone (518) 525-1404

317 S Manning Blvd
Ste 220
Albany, NY 12208
Phone (518) 525-6418

2 Empire Dr
Ste 202
Rensselaer, NY 12144
Phone (518) 286-4990

147 Hoosick St
Troy, NY 12180
Phone (518) 268-5749

2 New Hampshire Ave
Troy, NY 12180
Phone (518) 272-0331

2215 Burdett Ave
Troy, NY 12180
Phone (518) 271-3300

1300 Massachusetts Ave
Troy, NY 12180
Phone (518) 268-5000

Interoperability endpoints

  • Direct secure messaging: etheodosiou150408@direct.trinity-health.org

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 2

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": "1150761600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623196800000",
    "number": "1891730982",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "155 BORTHWICK AVE",
            "address_2": "SUITE 301",
            "city": "PORTSMOUTH",
            "state": "NH",
            "postal_code": "038017156",
            "telephone_number": "603-433-5226",
            "fax_number": "603-433-4939"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "155 BORTHWICK AVE",
            "address_2": "SUITE 301",
            "city": "PORTSMOUTH",
            "state": "NH",
            "postal_code": "038017156",
            "telephone_number": "603-433-5226",
            "fax_number": "603-433-4939"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1300 Massachusetts Avenue",
            "address_2": "Hildegard Medicus Cancer Center",
            "address_purpose": "LOCATION",
            "city": "Troy",
            "state": "NY",
            "postal_code": "121801628",
            "country_code": "US",
            "telephone_number": "518-268-5060",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "THEODOSIOU",
        "first_name": "ELENA",
        "middle_name": "NIKOU",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-20",
        "last_updated": "2021-06-09",
        "certification_date": "2021-05-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "ME",
            "license": "016524",
            "primary": false
        },
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "NY",
            "license": "290174",
            "primary": false
        },
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "NH",
            "license": "16333",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3092047",
            "state": "NH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "payer.credentialing@sphp.com",
            "affiliation": "N",
            "endpointDescription": "SPHP - Payer Credentialing",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "1300 Massachusetts Avenue",
            "address_2": "Hildegard Medicus Cancer Center",
            "city": "Troy",
            "state": "NY",
            "country_code": "US",
            "postal_code": "121801628",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Portsmouth, NH

Sources for this page

Verify at the official NPI Registry.