DR. NICOLE E IZHAKOFF M.D.
NPI 1043957913
Student in an Organized Health Care Education/Training Program in Saint Louis, MO

Q: What is Nicole Izhakoff's NPI number?

The NPI number for Nicole Izhakoff is 1043957913. It was assigned to this individual provider in the NPPES registry on May 12, 2022.

Q: What is Nicole Izhakoff's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Q: When was this NPI record last updated?

The NPPES record for Nicole Izhakoff was last updated on May 12, 2022. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since May 12, 2022PECOS Enrolled

1201 S GRAND BLVD, SAINT LOUIS, MO 63104(314) 977-4708(314) 977-1642 Get Directions Write a Review

NPPES record last updated: May 12, 2022. Verified against the NPPES registry weekly; last sync: July 26, 2026.

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About Dr. Nicole E Izhakoff M.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. NICOLE E IZHAKOFF M.D. (NPI 1043957913) is an individual student in an organized health care education/training program in Saint Louis, Missouri and active in the NPI registry since May 2022. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1043957913

Entity TypeIndividualFemale

Primary Taxonomy390200000X

Provider Legal NameDR. NICOLE E IZHAKOFFCredential: M.D.

Location Address1201 S GRAND BLVDSaint Louis, MO 63104-1016

Mailing Address1402 S Grand BlvdSaint Louis, MO 63104-1004 · (314) 977-4708 · Fax (314) 977-1642

Phone(314) 977-4708

Fax(314) 977-1642

Sole ProprietorNo

Enumeration DateMay 12, 2022

NPPES CertifiedMay 12, 2022

✔ NPI 1043957913 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care

Taxonomy Code390200000X

Definition

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

1201 S GRAND BLVD, Saint Louis, MO 63104

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Nicole E Izhakoff M.d. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.