Individual provider Active NPI

Nicholas Michael Smith, DPT, ATC

  • Physical Therapist
  • West Seneca, NY
National Provider Identifier
1093056103
Registry record updated Feb 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
035839 Issued in NY
Practice address
425 Meyer Rd
West Seneca, NY 14224-1954
Phone
(716) 677-4022
NPI assigned
Mar 14, 2013
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 7, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X 0011807 NY
Physical Therapy Clinic/Center 261QP2000X 035839 NY
Physical Therapist 225100000X 035839 NY Primary

Addresses

Primary practice location

425 Meyer Rd
West Seneca, NY 14224-1954

Mailing address

425 Meyer Rd
West Seneca, NY 14224-1954
Phone (716) 677-4022

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20131016000531 NY Practitioner - Physical Therapist in Private Practice 6002040540 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Western New York Fitness Rehabilitation PT PLLCGroup PAC ID 4082011275, 10 clinicians

Practice addresses (Care Compare)

425 Meyer Rd
West Seneca, NY 14224-1954
Phone (716) 563-4811

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
035839NYMDGeneral Practice Dentistry
0011807NYMDAthletic Trainer

Practice roles

OrganizationSpecialtyStatusNew patients
Western New York Fitness Rehabilitation, PT, PLLC Physical Therapy CurrentSince Feb 11, 2024 Accepting new patients
Advanced Care Physical Therapy Aquatics and Fitness PC Physical Therapist CurrentSince Nov 1, 2020 Accepting new patients
Western New York Fitness Rehabilitation, PT, PLLC Physical Therapist CurrentSince Jan 3, 2025 Accepting new patients

Locations

6000 Brockton Dr
Ste 107
Lockport, NY 14094
Phone (716) 201-1049

924 Main St
Niagara Falls, NY 14301

425 Meyer Rd
West Seneca, NY 14224
Phone (716) 563-4811

15 S Forest Rd
Williamsville, NY 14221
Phone (716) 204-8734

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1363219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707264000000",
    "number": "1093056103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "425 MEYER RD",
            "city": "WEST SENECA",
            "state": "NY",
            "postal_code": "142241954",
            "telephone_number": "716-677-4022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "425 MEYER RD",
            "city": "WEST SENECA",
            "state": "NY",
            "postal_code": "142241954",
            "telephone_number": "716-677-4022"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "NICHOLAS",
        "middle_name": "MICHAEL",
        "credential": "DPT, ATC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-03-14",
        "last_updated": "2024-02-07",
        "certification_date": "2024-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "NY",
            "license": "0011807",
            "primary": false
        },
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "NY",
            "license": "035839",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "035839",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Seneca, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.

Verify at the official NPI Registry.