Individual provider Active NPI

Alexandra Karadzas

  • Specialist
  • Staten Island, NY
National Provider Identifier
1982396925
Registry record updated May 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
1555379211 Issued in NY
Practice address
1250 Hylan Blvd Ste 9B1
Staten Island, NY 10305-1945
Phone
(917) 397-8947
Fax
(929) 226-6026
NPI assigned
May 25, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 25, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 1555379211 NY Primary

Addresses

Primary practice location

1250 Hylan Blvd Ste 9B1
Staten Island, NY 10305-1945

Mailing address

312 Stobe Ave
Staten Island, NY 10306-5236
Phone (917) 420-0305

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
1555379211NYMDSpecialist

NPI Registry JSON

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

{
    "created_epoch": "1684972800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684972800000",
    "number": "1982396925",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "312 STOBE AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103065236",
            "telephone_number": "917-420-0305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1250 HYLAN BLVD STE 9B1",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103051945",
            "telephone_number": "917-397-8947",
            "fax_number": "929-226-6026"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KARADZAS",
        "first_name": "ALEXANDRA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-05-25",
        "last_updated": "2023-05-25",
        "certification_date": "2023-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NY",
            "license": "1555379211",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 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.