Active NPI
David Nicholas, DO
- Student in an Organized Health Care Education/Training Program
- Syracuse, NY
National Provider Identifier
1013656933
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Student in an Organized Health Care Education/Training Program
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20220728002061 | MA | Order and Referring Only - 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
- dnicholas2755008@direct.trinity-health.org
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Binghamton, NY
- NPI 1518998699
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.