Organization Active NPI

Nightwater Health of New York, PC

  • Internal Medicine Physician
  • New York, NY
National Provider Identifier
1962112938
Registry record updated Jan 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
NIGHTWATER HEALTH OF NEW YORK, PC
Practice address
501 5TH Ave RM 1203
New York, NY 10017-7872
Phone
(917) 620-2633
Fax
(504) 617-6371
NPI assigned
Dec 1, 2022
Last updated
Jan 11, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 11, 2023

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

Authorized official

Name
Dr. Paul Ikemire, MDNPI 1477870210
Title
Ceo
Phone
(504) 717-3050

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

501 5TH Ave RM 1203
New York, NY 10017-7872

Mailing address

1 Blackford Dr
Exeter, NH 03833-4623
Phone (504) 717-3050

Other identifiers 1

IdentifierTypeStateIssuer
320401-01OtherNYNY BOARD OF MEDICINE

National Provider Directory

National Provider Directory

Locations

121 E 60th St
Apt 2D
New York, NY 10022
Phone (504) 717-3050

501 5th Ave
Rm 1203
New York, NY 10017
Phone (212) 992-9030

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1669852800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1673395200000",
    "number": "1962112938",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 BLACKFORD DR",
            "city": "EXETER",
            "state": "NH",
            "postal_code": "038334623",
            "telephone_number": "504-717-3050",
            "fax_number": "504-617-6371"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 5TH AVE RM 1203",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100177872",
            "telephone_number": "917-620-2633",
            "fax_number": "504-617-6371"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NIGHTWATER HEALTH OF NEW YORK, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-12-01",
        "last_updated": "2023-01-11",
        "certification_date": "2023-01-11",
        "status": "A",
        "authorized_official_last_name": "IKEMIRE",
        "authorized_official_first_name": "PAUL",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "504-717-3050",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NY BOARD OF MEDICINE",
            "identifier": "320401-01",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.