Nicholas Wilson, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

28118 Issued in MA

Practice address

259 Elm St
Somerville, MA 02144-2950

Phone

(617) 787-8700

NPI assigned

Feb 8, 2020

Sex

Male

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 MA

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Boston Sports Medicine IncGroup PAC ID 9032163985, 28 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/11813/brand/1/csg/1/fhir/r4

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.

• Boston Sports Medicine Inc

  • Physical Therapist
  • Allston, MA
  • NPI 1245217546
  Medicare reassignment Care Compare group NPD
• Lakeside Center for Autism, LLC

  • Speech-Language Pathologist
  • Bellevue, WA
  • NPI 1588802953
  NPD
• Ican America

  • Multi-Specialty Clinic/Center
  • Phoenix, AZ
  • NPI 1508325929
  NPD (past)

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

{
    "created_epoch": "1581120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733788800000",
    "number": "1235761156",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 322",
            "city": "ALLSTON",
            "state": "MA",
            "postal_code": "021340003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "259 ELM ST",
            "city": "SOMERVILLE",
            "state": "MA",
            "postal_code": "021442950",
            "telephone_number": "617-787-8700"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5150 Village Park Dr SE",
            "address_purpose": "LOCATION",
            "city": "Bellevue",
            "state": "WA",
            "postal_code": "980066652",
            "country_code": "US",
            "telephone_number": "425-457-0620",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILSON",
        "first_name": "NICHOLAS",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-02-08",
        "last_updated": "2024-12-10",
        "certification_date": "2024-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MA",
            "license": "28118",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Charlene Carol Williams, RN
• Jamie Williamson
• Chelsea Willis
• Sofia Wilson-Rae, M.A.
• Elle Wilson
• Laura Kay Winebrenner, MSW
• David W Wing, M.D.
• Sharlene W. Wing, PT
• Sarah L Wingerter, MD
• Amy Winkel-Gois, IBCLC

• Physical Therapist in Somerville, MA
• Providers in Somerville, MA by specialty
• Physical Therapist in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2024; 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.