Individual provider Active NPI

David Nicholas, DO

  • Student in an Organized Health Care Education/Training Program
  • Syracuse, NY
National Provider Identifier
1013656933
Registry record updated Jun 15, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
750 E Adams St
Syracuse, NY 13210-2306
Phone
(315) 464-4363
NPI assigned
May 31, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 15, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 342962 NY
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

750 E Adams St
Syracuse, NY 13210-2306

Mailing address

750 E Adams St
Syracuse, NY 13210-1834
Phone (315) 464-4363

Other practice location 1

33-57 Harrison St
Johnson City, NY 13790-2107
Phone (607) 763-6412

Other practice location 2

Baystate Medical Center 759 Chestnut Street
Springfield, MA 01199-0001
Phone (607) 221-9348

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220728002061 MA Order and Referring Only - General SurgeryPractitioner - General Surgery 2062894645

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
University of New England, College of Osteo Medicine, 2022
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

33 Lewis Rd
Binghamton, NY 13905-1013

33 Lewis Rd FL
Suite 2
Binghamton, NY 13905-1054

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

Interoperability endpoints

  • Direct secure messaging: dnicholas2755008@direct.trinity-health.org

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1653955200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781481600000",
    "number": "1013656933",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "750 E ADAMS ST",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132101834",
            "telephone_number": "315-464-4363",
            "fax_number": "315-464-4854"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "750 E ADAMS ST",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132102306",
            "telephone_number": "315-464-4363"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "33-57 Harrison St",
            "address_purpose": "LOCATION",
            "city": "Johnson City",
            "state": "NY",
            "postal_code": "137902107",
            "country_code": "US",
            "telephone_number": "607-763-6412",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "Baystate Medical Center 759 Chestnut Street",
            "address_purpose": "LOCATION",
            "city": "Springfield",
            "state": "MA",
            "postal_code": "011990001",
            "country_code": "US",
            "telephone_number": "607-221-9348",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NICHOLAS",
        "first_name": "DAVID",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-05-31",
        "last_updated": "2026-06-15",
        "certification_date": "2026-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NY",
            "license": "342962",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Syracuse, NY

Sources for this page

Verify at the official NPI Registry.