Individual provider Active NPI

Alexandra Nickerson, PA-C

  • Physician Assistant
  • Long Island City, NY
National Provider Identifier
1982401618
Registry record updated Nov 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
1041 47TH Ave
Long Island City, NY 11101-5416
Phone
(212) 385-3700
NPI assigned
Feb 28, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 19, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

1041 47TH Ave
Long Island City, NY 11101-5416

Mailing address

1027 46TH Ave FL 3
Long Island City, NY 11101-5245
Phone (212) 385-3700

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260401000765 NY Practitioner - Physician Assistant 2769967355 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bobby Buka, M.D., P.C.Group PAC ID 0547351140, 140 clinicians

Practice addresses (Care Compare)

220 Front St
New York, NY 10038-2033
Phone (212) 385-3700

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Bobby Buka, M.D., P.C. CurrentSince Aug 29, 2017 Accepting new patients
Derm Specs of PA PLLC CurrentSince Feb 23, 2026 Accepting new patients
Out East Medical PastSince Jun 15, 2021 Accepting new patients
Atlas Infectious Disease Practice PLLC Past Accepting new patients
Mount Sinai Hospital Past Accepting new patients

Locations

3179 Steinway St
Astoria, NY 11103

1163 Myrtle Ave
Brooklyn, NY 11206

1027 46th Ave
Fl 3
Long Island City, NY 11101
Phone (212) 285-3700

625 10th Ave
New York, NY 10036

214 Sullivan St
New York, NY 10012

2121 Adam Clayton Powell Jr Blvd
New York, NY 10027
Phone (718) 534-8190

1425 2nd Ave
New York, NY 10021

3531 Long Beach Rd
Oceanside, NY 11572

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/22363/brand/1/csg/1/fhir/r4
  • FHIR API: https://fhir4.healow.com/fhir/r4/BFCDAA

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1740700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763510400000",
    "number": "1982401618",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1027 46TH AVE FL 3",
            "city": "LONG ISLAND CITY",
            "state": "NY",
            "postal_code": "111015245",
            "telephone_number": "212-385-3700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1041 47TH AVE",
            "city": "LONG ISLAND CITY",
            "state": "NY",
            "postal_code": "111015416",
            "telephone_number": "212-385-3700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICKERSON",
        "first_name": "ALEXANDRA",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-02-28",
        "last_updated": "2025-11-19",
        "certification_date": "2025-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Long Island City, NY

Sources for this page

Verify at the official NPI Registry.