Nicholas Tucker Bradshaw, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

047355 Issued in NY

Practice address

350 Robbins LN
Syosset, NY 11791-6009

Phone

(516) 513-1510

NPI assigned

Jun 23, 2021

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Lifetime Physical Therapy and Chiropractic Rehabilitation PLLCGroup PAC ID 3971807025, 3 clinicians

Practice addresses (Care Compare)

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 and National Provider Directory roles.

• Lifetime Physical Therapy and Chiropractic Rehabilitation PLLC

  • Physical Therapist
  • Garden City, NY
  • NPI 1821453572
  Medicare reassignment Care Compare group NPD
• One Physical Therapy, P.C.

  • Physical Therapist
  • Syosset, NY
  • NPI 1235436874
  Medicare reassignment NPD
• Lifetime Physical Therapy & Chiropractic PLLC

  • Chiropractor
  • West Harrison, NY
  • NPI 1295118073

  Physical Therapist

  NPD (past)

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

{
    "created_epoch": "1624406400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625529600000",
    "number": "1750950754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33 CAMEO LN",
            "city": "WESTBURY",
            "state": "NY",
            "postal_code": "115905719",
            "telephone_number": "516-404-9522"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 ROBBINS LN",
            "city": "SYOSSET",
            "state": "NY",
            "postal_code": "117916009",
            "telephone_number": "516-513-1510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRADSHAW",
        "first_name": "NICHOLAS",
        "middle_name": "TUCKER",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-06-23",
        "last_updated": "2021-07-06",
        "certification_date": "2021-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NH",
            "license": "4813",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "047355",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Robert William Borzone, DC, LAC
• Sharon Borzone, DC
• Daniel Bosshart
• Sharon Debra Botter, LMSW
• Faye Bottone, LCSW-R
• Lauryn S Brady, LCSW
• Melanie Bram
• Gillian Brennan, PA
• Edward Brenner, PSY.D.
• Jill Anne Bressler, MD

• Physical Therapist in Syosset, NY
• Providers in Syosset, 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 Jul 6, 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.