NIKITA O. SHULZHENKO MD
NPI 1780143503
Student in an Organized Health Care Education/Training Program in Newark, NJ

Q: What is Nikita Shulzhenko's NPI number?

The NPI number for Nikita Shulzhenko is 1780143503. It was assigned to this individual provider in the NPPES registry on March 19, 2019.

Q: What is Nikita Shulzhenko'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 Nikita Shulzhenko was last updated on November 11, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 months 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.

Active since March 19, 2019PECOS Enrolled

140 BERGEN ST STE E1620, NEWARK, NJ 07103(973) 972-5377(973) 972-8268 Get Directions Write a Review

NPPES record last updated: November 11, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Nov 11, 2025, Mar 19, 2019 (2 updates tracked since 2019).

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About Nikita O. Shulzhenko Md NPPES

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

NIKITA O. SHULZHENKO MD (NPI 1780143503) is an individual student in an organized health care education/training program in Newark, New Jersey and active in the NPI registry since March 2019. He is enrolled in Medicare PECOS, maintains a secondary practice location in York, and is a graduate of University Of Wisconsin School Of Medicine (2019).

NPPES Registry Identity

NPI1780143503

Entity TypeIndividualMale

Primary Taxonomy390200000X

Provider Legal NameNIKITA O. SHULZHENKOCredential: MD

Location Address140 BERGEN ST STE E1620Newark, NJ 07103-2425

Mailing Address140 Bergen St Ste E1620Newark, NJ 07103-2425 · (973) 972-5377 · Fax (973) 972-8268

Phone(973) 972-5377

Fax(973) 972-8268

Sole ProprietorNo

Medical School CMSUniversity Of Wisconsin School Of MedicineGraduated 2019

Enumeration DateMarch 19, 2019

Last NPPES UpdateNovember 11, 20252 updates tracked since enumeration

NPPES CertifiedNovember 11, 2025

✔ NPI 1780143503 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ 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.

Also ListedPlastic SurgeryTaxonomy 208200000X · License MD488807 (PA)

140 BERGEN ST STE E1620, Newark, NJ 07103

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Secondary Practice Location 1

Location 125 Monument Rd Ste 220BYork, PA 17403-5049 · Phone (717) 812-2390 · Fax (717) 812-2388

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Nikita O. Shulzhenko Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID4789176017

PECOS Enrollment IDI20251125000165

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.

Other Providers at the Same Location NPPES 9

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

CASEY MARTINEZ

Student in an Organized Health Care Education/Training Program