Individual provider Active NPI

Nicholas Stephen Jodush, PT

  • Physical Therapist
  • Buffalo, NY
National Provider Identifier
1154197994
Registry record updated Dec 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
815 Hopkins Rd
Buffalo, NY 14221-2320
Phone
(716) 688-0111
NPI assigned
Dec 4, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X Primary

Addresses

Primary practice location

815 Hopkins Rd
Buffalo, NY 14221-2320

Mailing address

115 Arland Ave
Olean, NY 14760-1559
Phone (716) 790-1599

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231227002800 NY Practitioner - Physical Therapist in Private Practice 3779933171 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Therapy Services PT and OTGroup PAC ID 9234503152, 9 clinicians

Practice addresses (Care Compare)

2330 Maple Rd
Williamsville, NY 14221-4000
Phone (716) 778-4877

6900 Buckley Rd
Syracuse, NY 13212-4042
Phone (631) 467-3700

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Therapy Services PT and OT Physical Therapist CurrentSince Dec 11, 2023 Accepting new patients
Therapy Services PT and OT Physical Therapist CurrentSince Dec 11, 2023 Accepting new patients
Therapy Services PT and OT Physical Therapist Past Accepting new patients

Locations

4933 Old Greenwood Rd
Fort Smith, AR 72903

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": "1701648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701648000000",
    "number": "1154197994",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 ARLAND AVE",
            "city": "OLEAN",
            "state": "NY",
            "postal_code": "147601559",
            "telephone_number": "716-790-1599"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "815 HOPKINS RD",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142212320",
            "telephone_number": "716-688-0111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JODUSH",
        "first_name": "NICHOLAS",
        "middle_name": "STEPHEN",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-12-04",
        "last_updated": "2023-12-04",
        "certification_date": "2023-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Buffalo, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2023; 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.