Individual provider Active NPI

Nicole K Houck

  • Occupational Therapist
  • Buffalo, NY
National Provider Identifier
1174038616
Registry record updated Dec 6, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
021876-1 Issued in NY
Practice address
2128 Elmwood Ave
Buffalo, NY 14207-1910
Phone
(716) 566-5007
NPI assigned
Dec 6, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 6, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 021876-1 NY Primary
Occupational Therapist 225X00000X

Addresses

Primary practice location

2128 Elmwood Ave
Buffalo, NY 14207-1910

Mailing address

2128 Elmwood Ave
Buffalo, NY 14207-1910
Phone (716) 566-5007

Other identifiers 1

IdentifierTypeStateIssuer
01465154MedicaidNY

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180112001175 NY Practitioner - Occupational Therapist in Private Practice 2668731985 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
State University of New York at Buffalo School of Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
People IncGroup PAC ID 3375457765, 15 clinicians

Practice addresses (Care Compare)

800 Hertel Ave
Suite 101
Buffalo, NY 14207-1906
Phone (716) 566-5050

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
021876NYMDPhysical Therapist
021876-1NYMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
People Inc CurrentSince Jan 1, 2017 Accepting new patients
People Inc CurrentSince Jan 1, 2017 Accepting new patients
People Inc. CurrentSince Jul 21, 2024 Accepting new patients
Medical Practitioner Services of Wny PC CurrentSince Nov 25, 2021 Accepting new patients

Locations

100 Horizon Park Dr
Brockport, NY 14420
Phone (585) 637-9130

2128 Elmwood Ave
Buffalo, NY 14207
Phone (716) 874-4500

800 Hertel Ave
Ste 104
Buffalo, NY 14207

800 Hertel Ave
Ste 101
Buffalo, NY 14207
Phone (716) 566-5007

800 Hertel Ave
#101
Buffalo, NY 14207
Phone (716) 566-5007

1219 N Forest Rd
Williamsville, NY 14221
Phone (716) 634-8152

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": "1512518400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1512518400000",
    "number": "1174038616",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2128 ELMWOOD AVE",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142071910",
            "telephone_number": "716-566-5007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2128 ELMWOOD AVE",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142071910",
            "telephone_number": "716-566-5007"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOUCK",
        "first_name": "NICOLE",
        "middle_name": "K",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-12-06",
        "last_updated": "2017-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NY",
            "license": "021876-1",
            "primary": true
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01465154",
            "state": "NY"
        }
    ],
    "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 6, 2017; 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.