Terriann Nicholson, MD

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

28664-1 Issued in NY

Practice address

622 W 168TH St
New York, NY 10032-3720

Phone

(212) 305-8075

NPI assigned

Apr 7, 2015

Sex

Female

Sole proprietor

Yes

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

Networks

• Healthfirst Medicare Network H9678
• Healthfirst Medicare Network H1722
• Healthfirst Medicare Network H5989
• Healthfirst Medicare Network H3359

Interoperability endpoints

• FHIR API: https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/R4/
• Direct secure messaging: tpn9001@direct.nyp.org
• FHIR API: https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/DSTU2/

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.

• North Shore-Lij Medical PC

  • Urology Physician
  • Great Neck, NY
  • NPI 1053688572
  Medicare reassignment NPD
• Trustees of Columbia University in the City of New York

  • Surgery Physician
  • New York, NY
  • NPI 1508266347

  Psychiatry

  Medicare reassignment NPD
• Trustees of Columbia University in the City of New York

  • Internal Medicine Physician
  • New York, NY
  • NPI 1699289488
  NPD
• The New York and Presbyterian Hospital

  • Psychiatric Hospital
  • New York, NY
  • NPI 1609970011
  NPD (past)

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

{
    "created_epoch": "1428364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1557792000000",
    "number": "1255727111",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25527 148TH AVE",
            "city": "ROSEDALE",
            "state": "NY",
            "postal_code": "114222803",
            "telephone_number": "347-423-8286"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "622 W 168TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100323720",
            "telephone_number": "212-305-8075"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICHOLSON",
        "first_name": "TERRIANN",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-04-07",
        "last_updated": "2019-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NY",
            "license": "28664-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• James Mark Anthony Nicholson, LMT
• Lauren Nicholson
• Ronald Nicholson
• Susan Nicholson, M.D.
• Tara Nicholson, ACNP
• Ursula Nicholson
• William Thomas Nicholson
• Nick M Mobilia, DDS, PC
• Nick Yoon Physical Therapy P.C.
• Gilbert A. Nick, LCSW, MPA

• Psychiatry Physician in New York, NY
• Providers in New York, NY by specialty
• Psychiatry Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2019; 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.