Individual provider Active NPI

Nicole Tucker

  • Prosthetic/Orthotic Supplier
  • Bronx, NY
National Provider Identifier
1154275196
Registry record updated Feb 25, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Prosthetic/Orthotic SupplierTaxonomy code 335E00000X
License
227820757 Issued in NY
Practice address
1130 Pelham Pkwy S Apt 4H
Bronx, NY 10461-1024
Phone
(203) 807-7027
NPI assigned
Feb 25, 2026
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 25, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Prosthetic/Orthotic Supplier 335E00000X 227820757 NY Primary

Addresses

Primary practice location

1130 Pelham Pkwy S Apt 4H
Bronx, NY 10461-1024

Mailing address

1130 Pelham Pkwy S Apt 4H
Bronx, NY 10461-1024
Phone (203) 807-7027

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

State licenses

LicenseStateTypeSpecialty
227820757NYMDProsthetic/Orthotic Supplier

Practice roles

OrganizationSpecialtyStatusNew patients
Starmotherprojectinc Prosthetic/Orthotic Supplier Current Accepting new patients

Organizations & group practices 1

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": "1771977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1771977600000",
    "number": "1154275196",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1130 PELHAM PKWY S APT 4H",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104611024",
            "telephone_number": "203-807-7027"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1130 PELHAM PKWY S APT 4H",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104611024",
            "telephone_number": "203-807-7027"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TUCKER",
        "first_name": "NICOLE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2026-02-25",
        "last_updated": "2026-02-25",
        "certification_date": "2026-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": "NY",
            "license": "227820757",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 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.