Individual provider Active NPI

Nicholas Brockway, DPT

  • Physical Therapist
  • Kingston, NY
National Provider Identifier
1255701827
Registry record updated Sep 25, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
039462 Issued in NY
Practice address
340 Plaza Rd
Kingston, NY 12401-2975
Phone
(845) 339-4722
NPI assigned
Sep 25, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 039462 NY Primary

Addresses

Primary practice location

340 Plaza Rd
Kingston, NY 12401-2975

Mailing address

340 Plaza Rd
Kingston, NY 12401-2975
Phone (845) 339-4722

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)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Kingston Physical-Occupational Therapy & Sports Rehab PLLC Physical Therapist CurrentSince Sep 17, 2015 Accepting new patients

Locations

340 Plaza Rd
Kingston, NY 12401
Phone (845) 339-4139

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": "1443139200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1443139200000",
    "number": "1255701827",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "340 PLAZA RD",
            "city": "KINGSTON",
            "state": "NY",
            "postal_code": "124012975",
            "telephone_number": "845-339-4722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "340 PLAZA RD",
            "city": "KINGSTON",
            "state": "NY",
            "postal_code": "124012975",
            "telephone_number": "845-339-4722"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROCKWAY",
        "first_name": "NICHOLAS",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-09-25",
        "last_updated": "2015-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "039462",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kingston, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2015; 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.