Individual provider Active NPI

Nicholas Edward Tedeschi, DPT

  • Physical Therapist
  • West Mifflin, PA
National Provider Identifier
1174047823
Registry record updated Mar 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
30335 Issued in MD
Practice address
500 N Lewis Run Rd
West Mifflin, PA 15122-3056
Phone
(724) 344-9001
NPI assigned
Aug 2, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 26, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT026198 PA
Physical Therapist 225100000X 30335 MD Primary

Addresses

Primary practice location

500 N Lewis Run Rd
West Mifflin, PA 15122-3056

Mailing address

976 Calkins Rd
Wellsboro, PA 16901-7695
Phone (724) 344-9001

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170927000395 PA Practitioner - Physical Therapist in Private Practice 1658645817 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
30335MDMDPharmacist
PT026198PAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Drayer Physical Therapy Institute LLC Physical Therapist Current Accepting new patients
Drayer Physical Therapy Institute LLC CurrentSince Oct 9, 2023 Accepting new patients
Drayer Physical Therapy Institute LLC Physical Therapist CurrentSince Oct 9, 2023 Accepting new patients

Locations

1200 Corporate Dr
Ste 400
Hoover, AL 35242
Phone (423) 238-7568

3771 Peters Mountain Rd
Halifax, PA 17032
Phone (717) 896-7612

Organizations & group practices 3

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": "1501632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742947200000",
    "number": "1174047823",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "976 CALKINS RD",
            "city": "WELLSBORO",
            "state": "PA",
            "postal_code": "169017695",
            "telephone_number": "724-344-9001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 N LEWIS RUN RD",
            "city": "WEST MIFFLIN",
            "state": "PA",
            "postal_code": "151223056",
            "telephone_number": "724-344-9001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TEDESCHI",
        "first_name": "NICHOLAS",
        "middle_name": "EDWARD",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-08-02",
        "last_updated": "2025-03-26",
        "certification_date": "2025-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "PA",
            "license": "PT026198",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MD",
            "license": "30335",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Mifflin, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.