Active NPI
Kunikazu David Nishimura, PT, DPT
- Physical Therapist
- Paramus, NJ
National Provider Identifier
1700515665
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 40QA02092800
- Practice address
- 4 Forest Ave FL 1
Paramus, NJ 07652-5237 - Phone
- (201) 977-4441
- NPI assigned
- Jun 7, 2022
- 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 | 40QA02092800 | NJ | Primary |
Addresses
Primary practice location
4 Forest Ave FL 1
Paramus, NJ 07652-5237
Mailing address
426 3Rd Ave
Lyndhurst, NJ 07071-1517
Phone (862) 754-3566
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 053227 | NY | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lifelong Strong Health LLC | Physical Therapist | Current | Accepting new patients |
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1654560000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1654560000000",
"number": "1700515665",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "426 3RD AVE",
"city": "LYNDHURST",
"state": "NJ",
"postal_code": "070711517",
"telephone_number": "862-754-3566"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4 FOREST AVE FL 1",
"city": "PARAMUS",
"state": "NJ",
"postal_code": "076525237",
"telephone_number": "201-977-4441"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NISHIMURA",
"first_name": "KUNIKAZU",
"middle_name": "DAVID",
"credential": "PT, DPT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-06-07",
"last_updated": "2022-06-07",
"certification_date": "2022-06-07",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NJ",
"license": "40QA02092800",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Paramus, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.