Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Nickie Douroudakis, PA

Individual provider Medical Physician Assistant · NPI 1265561435

Nickie Douroudakis, PA is a Physician Assistant in Greenvale, New York. Qualified in 2000, 26 years ago. Practices with White Plains Physician Services PC, a 384-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in New York.

Years since qualifying
26
Licensed in
NY
In the registry since
2007
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

See every abbreviation used in this directory →

Practice location Address checks out

2200 Northern Blvd Ste 121
Greenvale, NY 11548-1220
Phone: (516) 705-1044
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 2510 30th Ave, Long Island City, NY 11102-2448 — (718) 267-4245

Specialties & licences

Medical Physician Assistant (primary) Taxonomy 363AM0700X · Licence 008029 (NY)

Record details

NPI number1265561435
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA
Sole proprietorNo
NPI enumeratedMarch 5, 2007
Last updated in NPPESAugust 11, 2022
Certification dateAugust 11, 2022

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2000 (26 years in practice)
Group practice White Plains Physician Services Pc — 384 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare