Nicholas Boulanger, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT032810 Issued in PA

Practice address

1027 Country Club Rd
Monongahela, PA 15063-1553

Phone

(724) 258-6211

Fax

(724) 258-6225

NPI assigned

Jan 16, 2025

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Valley Outpatient Rehabilitation

  • Specialist
  • Monongahela, PA
  • NPI 1285696179
  NPD (past)

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

{
    "created_epoch": "1736985600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736985600000",
    "number": "1366253643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4325 RTE 51 N",
            "city": "ROSTRAVER TWP",
            "state": "PA",
            "postal_code": "150123535",
            "telephone_number": "724-565-5806",
            "fax_number": "724-483-0290"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1027 COUNTRY CLUB RD",
            "city": "MONONGAHELA",
            "state": "PA",
            "postal_code": "150631553",
            "telephone_number": "724-258-6211",
            "fax_number": "724-258-6225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOULANGER",
        "first_name": "NICHOLAS",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-01-16",
        "last_updated": "2025-01-16",
        "certification_date": "2025-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "PA",
            "license": "PT032810",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Wendy Janine Biagini
• Olivia Ann Bickmore, CRNP
• Linda Marie Bisceglia, DC
• Thumrong Boonvisudhi, M.D.
• Lora Borrelli-Sowers, MS, LPC
• Diana Brean, SL
• Jill E Brekosky, C.R.N.P.
• Leah Briston, PA-C
• Mary Claire Brough
• Lisa Brown, SL

• Physical Therapist in Monongahela, PA
• Providers in Monongahela, PA by specialty
• Physical Therapist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2025; 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.