Nicholas Chupick, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

TE012517 Issued in PA

Practice address

276 E Grove St Ste 2
Clarks Green, PA 18411-1723

Phone

(570) 319-6903

NPI assigned

Sep 14, 2020

Last updated

Sep 14, 2020By the provider in NPPES

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

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Impact Physio

  • Physical Therapist
  • South Abington Township, PA
  • NPI 1033459615
  NPD

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

{
    "created_epoch": "1600041600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600041600000",
    "number": "1396350443",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1510 APPLEWOOD ACRES",
            "city": "SOUTH ABINGTON TOWNSHIP",
            "state": "PA",
            "postal_code": "184112849",
            "telephone_number": "570-877-9865"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "276 E GROVE ST STE 2",
            "city": "CLARKS GREEN",
            "state": "PA",
            "postal_code": "184111723",
            "telephone_number": "570-319-6903"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHUPICK",
        "first_name": "NICHOLAS",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-09-14",
        "last_updated": "2020-09-14",
        "certification_date": "2020-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "PA",
            "license": "TE012517",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Behavioral Healthcare Center, P.C.
• Alicia Marie Bognatz
• Adrianna Borkowski
• Brightway Medical PC
• Vincent Carolan, MA, CAADC, LPC
• Terence A Cochran, M.D.
• Kimberly June Conaboy
• Colleen Contrisciane, LPC
• Diagnostic Imaging Centers of Nepa, LLC (Advanced Imaging Specialists)
• Jessica Failing

• Physical Therapy Assistant in Clarks Green, PA
• Providers in Clarks Green, PA by specialty
• Physical Therapy Assistant in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2020; 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.