Individual provider Active NPI

Vasilis Nomikos, OTRL

  • Specialist
  • Levittown, NY
National Provider Identifier
1982744587
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
012940-1 Issued in NY
Practice address
41 Blacksmith Rd
Levittown, NY 11756-3105
Phone
(516) 390-5652
NPI assigned
Feb 6, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 012940-1 NY Primary

Addresses

Primary practice location

41 Blacksmith Rd
Levittown, NY 11756-3105

Mailing address

41 Blacksmith Rd
Levittown, NY 11756-3105
Phone (516) 390-5652

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
012940-1NYMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1170720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1982744587",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "41 BLACKSMITH RD",
            "city": "LEVITTOWN",
            "state": "NY",
            "postal_code": "117563105",
            "telephone_number": "516-390-5652"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "41 BLACKSMITH RD",
            "city": "LEVITTOWN",
            "state": "NY",
            "postal_code": "117563105",
            "telephone_number": "516-390-5652"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOMIKOS",
        "first_name": "VASILIS",
        "name_prefix": "Mr.",
        "credential": "OTRL",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-06",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NY",
            "license": "012940-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Levittown, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.