Individual provider Active NPI

Nichole Becker

  • Physical Therapist
  • Amherst, NY
National Provider Identifier
1275166324
Registry record updated Oct 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
046441 Issued in NY
Practice address
3925 Sheridan Dr
Amherst, NY 14226-1738
Phone
(716) 250-6500
NPI assigned
Feb 18, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2020

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 046441 NY Primary

Addresses

Primary practice location

3925 Sheridan Dr
Amherst, NY 14226-1738

Mailing address

PO Box 75868
Baltimore, MD 21275-5868

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address nbecker28794@direct.orthovirginia.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, NY2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20200303000009 DC Practitioner - Physical Therapist in Private Practice 6608203799 Reassigns benefits to 1 organization
I20201104000351 NY Practitioner - Physical Therapist in Private Practice 6608203799 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

101 Sterling Dr
Orchard Park, NY 14127-1566
Phone (631) 467-3700

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
046441NYMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Orthovirginia, Inc CurrentSince Feb 24, 2020 Accepting new patients
PRN Physical, Occupational and Speech Therapy Network, PLLC CurrentSince Sep 1, 2024 Accepting new patients
PRN Physical, Occupational and Speech Therapy Network, PLLC Physical Therapist CurrentSince Sep 1, 2024 Accepting new patients
Excelsior Orthopaedics, LLP CurrentSince Oct 26, 2020 Accepting new patients
Orthovirginia, Inc CurrentSince Feb 24, 2020 Accepting new patients
Orthovirginia Inc. Current Accepting new patients
Excelsior Orthopaedics LLP Physical Therapist CurrentSince Oct 26, 2020 Accepting new patients

Locations

3925 Sheridan Dr
Buffalo, NY 14226
Phone (716) 250-6500

101 Sterling Dr
Orchard Park, NY 14127
Phone (716) 675-1022

2821 Wehrle Dr
Williamsville, NY 14221
Phone (716) 908-6374

2222 Sullivan Trl
Ste 105
Easton, PA 18040
Phone (574) 261-7058

6354 Walker Ln
Ste 300
Alexandria, VA 22310
Phone (703) 810-5210

8320 Old Courthouse Rd
Ste 401
Vienna, VA 22182
Phone (571) 999-7973

Organizations & group practices 7

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": "1581984000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604016000000",
    "number": "1275166324",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 75868",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212755868"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3925 SHERIDAN DR",
            "city": "AMHERST",
            "state": "NY",
            "postal_code": "142261738",
            "telephone_number": "716-250-6500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BECKER",
        "first_name": "NICHOLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-02-18",
        "last_updated": "2020-10-30",
        "certification_date": "2020-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "046441",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "nbecker28794@direct.orthovirginia.com",
            "affiliation": "N",
            "endpointDescription": "Nichole Becker direct address",
            "address_1": "8320 Old Courthouse Road",
            "address_2": "Ste 401",
            "city": "Vienna",
            "state": "VA",
            "country_code": "US",
            "postal_code": "221823811",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Amherst, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2020; 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.