Nicholas Robert Davidson, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

040634-1 Issued in NY

Practice address

5589 Transit Rd
East Amherst, NY 14051-1805

Phone

(716) 568-1251

Fax

(716) 568-1253

NPI assigned

Dec 30, 2016

Last updated

Apr 14, 2021By 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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

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.

• Perilli Physical Therapy PC

  dba Advantage Physical Therapy

  • Physical Therapist
  • Lockport, NY
  • NPI 1043891765
  NPD
• Ideal Rehabilitation LLC

  • Durable Medical Equipment & Medical Supplies
  • Tucson, AZ
  • NPI 1831353614
  NPD (past)

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

{
    "created_epoch": "1483056000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618358400000",
    "number": "1568907459",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "BOX 8000 DEPT 314",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142670002",
            "telephone_number": "716-213-0772",
            "fax_number": "716-324-5004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5589 TRANSIT RD",
            "city": "EAST AMHERST",
            "state": "NY",
            "postal_code": "140511805",
            "telephone_number": "716-568-1251",
            "fax_number": "716-568-1253"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIDSON",
        "first_name": "NICHOLAS",
        "middle_name": "ROBERT",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-12-30",
        "last_updated": "2021-04-14",
        "certification_date": "2021-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "040634-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "05018460",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Caroline Ann D'Souza, MD
• Marcelino Fabian D'Souza, MD
• Dominic Dalfonso, PT
• Andrea G Dan, LMSW
• Ping Dang
• Melissa Nicole Davis, RN/LPN
• Kathleen Mary Debellis
• Deberg Enterprises, LLC (AURA salt cave and wellness)
• Alison Rose Decirce, D.P.T.
• Yvonne Cabrera Deppe, R.N.

• Physical Therapist in East Amherst, NY
• Providers in East Amherst, NY by specialty
• Physical Therapist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2021; 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.