Nickolas Jon Boyol

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

299994 Issued in CA

Practice address

6451 El Camino Real Ste B2
Carlsbad, CA 92009-2800

Phone

(858) 755-5200

NPI assigned

Apr 1, 2021

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2020

Medicare assignment

May accept Medicare assignment

Group practices

Rise Physical Therapy IncGroup PAC ID 2062636079, 55 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

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.

• Rise Physical Therapy Inc

  • Physical Therapy Clinic/Center
  • Solana Beach, CA
  • NPI 1083038764
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1617235200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617235200000",
    "number": "1437737137",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2646 UNICORNIO ST",
            "city": "CARLSBAD",
            "state": "CA",
            "postal_code": "920095333",
            "telephone_number": "760-815-8680"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6451 EL CAMINO REAL STE B2",
            "city": "CARLSBAD",
            "state": "CA",
            "postal_code": "920092800",
            "telephone_number": "858-755-5200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOYOL",
        "first_name": "NICKOLAS",
        "middle_name": "JON",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-04-01",
        "last_updated": "2021-04-01",
        "certification_date": "2021-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "299994",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "www.risephysicaltherapy.com",
            "affiliation": "N",
            "endpointDescription": "website",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "6451 El Camino Real Ste B2",
            "city": "Carlsbad",
            "state": "CA",
            "country_code": "US",
            "postal_code": "920092800",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Michelle M Bourgerie, AMFT & APCC
• Madelyn Bourgoujian
• Barbara Jean Boutelle, P.T.
• David C Boutelle, P.T.
• Tod C Bowman, DDS
• Chloe Braamse, NP
• Jessica Adeline Bracha, LMFT
• Heather Lexus Bradford
• Bradley McCammack MD Inc
• Brittany Leigh Bradley

• Physical Therapist in Carlsbad, CA
• Providers in Carlsbad, CA by specialty
• Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2021; 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.