NICKIE DOUROUDAKIS PA
NPI 1265561435
Physician Assistant - Medical in Greenvale, NY

Active since March 05, 2007PECOS EnrolledAccepts Medicare Assignment
2200 NORTHERN BLVD STE 121, GREENVALE, NY 11548(516) 705-1044 Get Directions Write a Review

NPPES record last updated: August 11, 2022. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Nickie Douroudakis Pa NPPES

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

NICKIE DOUROUDAKIS PA (NPI 1265561435) is an individual medical provider in Greenvale, New York, licensed in New York (008029) and active in the NPI registry since March 2007. She is enrolled in Medicare PECOS, is affiliated with White Plains Hospital Center, and maintains a secondary practice location in Long Island City.

NPPES Registry Identity

NPI1265561435
Entity TypeIndividualFemale
Primary Taxonomy363AM0700X
Provider Legal NameNICKIE DOUROUDAKISCredential: PA
Location Address2200 NORTHERN BLVD STE 121Greenvale, NY 11548-1220
Mailing Address22112 59th AveOakland Gardens, NY 11364-1930 · (917) 453-8024
Sole ProprietorNo
Medical School CMSOtherGraduated 2000
Enumeration DateMarch 5, 2007
Last NPPES UpdateAugust 11, 2022
NPPES CertifiedAugust 11, 2022
NPI 1265561435 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyPhysician Assistant · MedicalPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363AM0700X
License Licensed in NY · 008029
2200 NORTHERN BLVD STE 121, Greenvale, NY 11548

Secondary Practice Location 1

Location 12510 30th AveLong Island City, NY 11102-2448 · Phone (718) 267-4245

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

Enrolled in Medicare and accepts Medicare assignment

Nickie Douroudakis Pa is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID8022117167
PECOS Enrollment IDI20070629000588
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.

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

White Plains Hospital Center

Acute Care Hospitals · White Plains, NY
5/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number330304
Location41 East Post R0adWhite Plains, NY 10601 · Westchester County
Emergency services Birthing friendly

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Physician Assistant
2200 NORTHERN BLVD STE 121
EAST HILLS, NY 11548
Clinic/Center (Urgent Care)
2200 NORTHERN BLVD STE 121
GREENVALE, NY 11548

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Nickie Douroudakis's NPI number?

The NPI number for Nickie Douroudakis is 1265561435. It was assigned to this individual provider in the NPPES registry on March 5, 2007.

Where is Nickie Douroudakis located?

Nickie Douroudakis practices at 2200 Northern Blvd Ste 121, Greenvale, NY 11548. The listed phone number is (516) 705-1044.

What is Nickie Douroudakis's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Medical, with taxonomy code 363AM0700X.

Is Nickie Douroudakis enrolled in Medicare?

Yes. Nickie Douroudakis is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Is Nickie Douroudakis affiliated with any hospitals?

According to CMS data, Nickie Douroudakis is affiliated with White Plains Hospital Center.

When was this NPI record last updated?

The NPPES record for Nickie Douroudakis was last updated on August 11, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.