Active NPI
Niko Ryan, DPT
- Physical Therapist
- Rochester, NY
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 050681
- Practice address
- 1555 Long Pond Rd
Rochester, NY 14626-4164 - Phone
- (585) 723-7000
- NPI assigned
- Sep 4, 2023
- 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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 050681 | NY | Primary |
Addresses
Primary practice location
1555 Long Pond Rd
Rochester, NY 14626-4164
Mailing address
620 Park Ave # 133
Rochester, NY 14607-2943
Phone (603) 832-8298
Other practice location 1
2655 Ridgeway Ave
Rochester, NY 14626-4296
Phone (603) 832-8298
Other names 1
- Sarah Nesic
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CO
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2023
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
Denver, CO 80246
Phone (866) 525-3175
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 050681 | NY | MD | Orthodontics and Dentofacial Orthopedic Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Intermountain Medical Group Denver, LLC | Current | Accepting new patients | |
| Intermountain Medical Group Denver, LLC | Current | Accepting new patients | |
| Colorado Luna Care Physical Therapy LLC | Physical Therapist | Current | Accepting new patients |
| Intermountain Medical Group Denver, LLC | Current | Accepting new patients |
Locations
500 Eldorado Blvd
Bldg 4
Broomfield, CO 80021
Phone (303) 812-4790
501 S Cherry St
Fl 11
Denver, CO 80246
Phone (309) 530-8782
8550 W 38th Ave
Ste 100
Wheat Ridge, CO 80033
Phone (303) 467-4100
Organizations & group practices 4
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.
-
- Physical Therapist
- Denver, CO
- NPI 1891461125
-
- Family Medicine Physician
- Denver, CO
- NPI 1083021083
-
- Sports Medicine (Orthopaedic Surgery) Physician
- Denver, CO
- NPI 1083598874
-
- Family Medicine Physician
- Wheat Ridge, CO
- NPI 1154967719
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1693785600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1693785600000",
"number": "1417733619",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "620 PARK AVE # 133",
"city": "ROCHESTER",
"state": "NY",
"postal_code": "146072943",
"telephone_number": "603-832-8298"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1555 LONG POND RD",
"city": "ROCHESTER",
"state": "NY",
"postal_code": "146264164",
"telephone_number": "585-723-7000"
}
],
"practiceLocations": [
{
"address_1": "2655 Ridgeway Ave",
"address_purpose": "LOCATION",
"city": "Rochester",
"state": "NY",
"postal_code": "146264296",
"country_code": "US",
"telephone_number": "603-832-8298",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "RYAN",
"first_name": "NIKO",
"name_prefix": "Dr.",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2023-09-04",
"last_updated": "2023-09-04",
"certification_date": "2023-09-04",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NY",
"license": "050681",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "SARAH",
"last_name": "NESIC",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in Rochester, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2023; 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.