Jimmy Colapo Niduaza, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

013604-01 Issued in NY

Practice address

3804 Bailey Ave Apt A3
Bronx, NY 10463-2541

Phone

(347) 917-6247

NPI assigned

Feb 22, 2023

Last updated

Jun 6, 2026By 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

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.

• Blveoceans Therapy Services LLC

  • Physical Therapy Clinic/Center
  • Bronx, NY
  • NPI 1033042197
  NPD Authorized official
• Patient First Medical Practice PC

  • Geriatric Medicine (Internal Medicine) Physician
  • Brooklyn, NY
  • NPI 1255067955
  NPD (past)
• Medical Director Services PC

  • Geriatric Medicine (Internal Medicine) Physician
  • Princess Anne, MD
  • NPI 1871955807
  NPD (past)

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

{
    "created_epoch": "1677024000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780704000000",
    "number": "1538867189",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3804 BAILEY AVE APT A3",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104632541",
            "telephone_number": "347-917-6247"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3804 BAILEY AVE APT A3",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104632541",
            "telephone_number": "347-917-6247"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIDUAZA",
        "first_name": "JIMMY",
        "middle_name": "COLAPO",
        "name_prefix": "Mr.",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-02-22",
        "last_updated": "2026-06-06",
        "certification_date": "2026-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "NY",
            "license": "013604-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Constantine John Nicolas, D.C.
• Nicole Burrell
• Christine Nicoleau, MD
• Joan Nicoletti, OT
• Marin Nicu, MD
• Dana M Nieder
• Camilla Niedzwiedz
• Jessica Ann Nielsen, LICSW
• Natalia Nielsen
• Marcus C. Niemi, P.A.

• Physical Therapy Assistant in Bronx, NY
• Providers in Bronx, NY by specialty
• Physical Therapy Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2026; 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.