Individual provider Active NPI

Sharon Taylor-Nicolas, PTA

  • Physical Therapy Assistant
  • Garden City, NY
National Provider Identifier
1629869839
Registry record updated May 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
010159-01 Issued in NY
Practice address
800 E Gate Blvd
Garden City, NY 11530-2105
Phone
(516) 745-8050
Fax
(516) 745-6766
NPI assigned
May 15, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 15, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 010159-01 NY Primary

Addresses

Primary practice location

800 E Gate Blvd
Garden City, NY 11530-2105

Mailing address

296 Community Dr
Smithtown, NY 11787-3878
Phone (516) 250-4918

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
010159-01NYMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1747267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747267200000",
    "number": "1629869839",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "296 COMMUNITY DR",
            "city": "SMITHTOWN",
            "state": "NY",
            "postal_code": "117873878",
            "telephone_number": "516-250-4918"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 E GATE BLVD",
            "city": "GARDEN CITY",
            "state": "NY",
            "postal_code": "115302105",
            "telephone_number": "516-745-8050",
            "fax_number": "516-745-6766"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAYLOR-NICOLAS",
        "first_name": "SHARON",
        "credential": "PTA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-05-15",
        "last_updated": "2025-05-15",
        "certification_date": "2025-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "NY",
            "license": "010159-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Garden City, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2025; 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.