Coral D. Nicholas

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

203978-1 Issued in NY

Practice address

1316 Black River Blvd N
Rome, NY 13440-3601

Phone

(315) 336-3353

Fax

(315) 336-3356

NPI assigned

Jan 30, 2006

Last updated

Aug 30, 2012By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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

• Mohammed Seedat MD and Coral Nicholas MD PLLC

  • Pulmonary Disease Physician
  • Rome, NY
  • NPI 1851564942
  Medicare reassignment NPD
• Upstate Medical Anesthesiology Group, Inc.

  • General Acute Care Hospital
  • Syracuse, NY
  • NPI 1851485759
  NPD (past)

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

{
    "created_epoch": "1138579200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1346284800000",
    "number": "1184695884",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1316 BLACK RIVER BLVD N",
            "city": "ROME",
            "state": "NY",
            "postal_code": "134403601",
            "telephone_number": "315-336-3353",
            "fax_number": "315-336-3356"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1316 BLACK RIVER BLVD N",
            "city": "ROME",
            "state": "NY",
            "postal_code": "134403601",
            "telephone_number": "315-336-3353",
            "fax_number": "315-336-3356"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICHOLAS",
        "first_name": "CORAL",
        "middle_name": "D.",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-30",
        "last_updated": "2012-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NY",
            "license": "203978-1",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "NY",
            "license": "203978-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Heidi Nestved
• New Horizons Marriage and Family Therapy PLLC
• New York State
• Newton Medical Consultant PLLC
• Alexandria Mary Newton, DMD
• Valerie E Nicolaichuk III
• Tansha Morgan Nottingham, FNP-BC
• Nuccio Chiropractic PLLC
• Douglas Nuccio, D.C.
• Nunn's Hospital Supplies, Inc

• General Practice Physician in Rome, NY
• Providers in Rome, NY by specialty
• General Practice Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.