Active NPI
Nicholas Matthew Usuriello, ATC
- Athletic Trainer
- Canton, NY
National Provider Identifier
1275178550
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 004010
- Practice address
- 23 Romoda Dr
Canton, NY 13617-1423 - Phone
- (315) 229-1843
- NPI assigned
- Nov 11, 2019
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | 004010 | NY | Primary |
Addresses
Primary practice location
23 Romoda Dr
Canton, NY 13617-1423
Mailing address
22 Buck St Apt 2
Canton, NY 13617-1395
Phone (845) 596-8226
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 004010 | NY | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1573430400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1573430400000",
"number": "1275178550",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "22 BUCK ST APT 2",
"city": "CANTON",
"state": "NY",
"postal_code": "136171395",
"telephone_number": "845-596-8226"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "23 ROMODA DR",
"city": "CANTON",
"state": "NY",
"postal_code": "136171423",
"telephone_number": "315-229-1843"
}
],
"practiceLocations": [],
"basic": {
"last_name": "USURIELLO",
"first_name": "NICHOLAS",
"middle_name": "MATTHEW",
"name_prefix": "Mr.",
"credential": "ATC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-11-11",
"last_updated": "2019-11-11",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "NY",
"license": "004010",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Canton, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.