Individual provider Active NPI

Nikoloz Tsitsishvili, PTA

  • Physical Therapy Assistant
  • Brooklyn, NY
National Provider Identifier
1003737867
Registry record updated Jul 24, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
014639 Issued in NY
Practice address
2148 Ocean Ave
Brooklyn, NY 11229-1483
Phone
(718) 872-7002
NPI assigned
Jul 24, 2026
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 014639 NY Primary

Addresses

Primary practice location

2148 Ocean Ave
Brooklyn, NY 11229-1483

Mailing address

2245 Ocean Pkwy Apt 1F
Brooklyn, NY 11223-4858
Phone (347) 824-5795

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

NPI Registry JSON

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

{
    "created_epoch": "1784851200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784851200000",
    "number": "1003737867",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2245 OCEAN PKWY APT 1F",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112234858",
            "telephone_number": "347-824-5795"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2148 OCEAN AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112291483",
            "telephone_number": "718-872-7002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TSITSISHVILI",
        "first_name": "NIKOLOZ",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2026-07-24",
        "last_updated": "2026-07-24",
        "certification_date": "2026-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "NY",
            "license": "014639",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2026; 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.