Individual provider Active NPI

Nicole Surach, PT, DPT

  • Physical Therapist
  • Brooklyn, NY
National Provider Identifier
1780080044
Registry record updated Jun 14, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
0414921 Issued in NY
Practice address
41 Clark St
Brooklyn, NY 11201-2415
Phone
(646) 518-5566
Fax
(646) 805-2946
NPI assigned
Nov 14, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 14, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 40QA01582300 NJ
Physical Therapist 225100000X 0414921 NY Primary

Addresses

Primary practice location

41 Clark St
Brooklyn, NY 11201-2415

Mailing address

307 5TH Ave FL 6
New York, NY 10016-6575
Phone (212) 759-2282

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170823002198 NY Practitioner - Physical Therapist in Private Practice 6204159023 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Spear Physical and Occupational Therapy, LLCGroup PAC ID 6901832112, 582 clinicians

Practice addresses (Care Compare)

41 Clark St
Brooklyn, NY 11201-2415
Phone (646) 518-5566

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
041492NYMDPharmacist
40QA01582300NJMDPhysical Therapist
0414921NYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Spear Physical and Occupational Therapy, LLC Physical Therapist CurrentSince Aug 17, 2017 Accepting new patients

Locations

260 Court St
Brooklyn, NY 11231
Phone (646) 518-5560

41 Clark St
Brooklyn, NY 11201
Phone (646) 518-5566

71 N 7th St
Brooklyn, NY 11249
Phone (646) 829-2295

4334 32nd Pl
Ph
Long Island City, NY 11101
Phone (212) 500-0560

16 Park Pl
New York, NY 10007
Phone (212) 457-0878

729 7th Ave
Fl 12
New York, NY 10019
Phone (212) 930-7300

245 E 84th St
New York, NY 10028
Phone (212) 876-5400

30 Broad St
Bsmt A
New York, NY 10004
Phone (646) 790-7454

30 Broad St
New York, NY 10004
Phone (212) 530-0630

95 Chambers St
New York, NY 10007
Phone (646) 973-5437

2465 Broadway
New York, NY 10025
Phone (212) 712-1000

11 W 67th St
New York, NY 10023
Phone (212) 799-6700

7 E 14th St
New York, NY 10003
Phone (646) 973-5438

36 W 44th St
Ste 403
New York, NY 10036
Phone (212) 759-2280

450 Fashion Ave
Ste 1800
New York, NY 10123
Phone (646) 518-5555

630 3rd Ave
New York, NY 10017
Phone (212) 682-3191

307 5th Ave
Fl 6
New York, NY 10016
Phone (646) 790-7464

269 W 16th St
New York, NY 10011
Phone (646) 841-1411

143 E 34th St
New York, NY 10016
Phone (646) 841-1400

120 E 56th St
Rm 1010
New York, NY 10022
Phone (646) 790-7466

57 W 57th St
Fl 15
New York, NY 10019
Phone (212) 289-0700

220 Tompkins Ave
Pleasantville, NY 10570
Phone (914) 358-2900

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": "1415923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560470400000",
    "number": "1780080044",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "307 5TH AVE FL 6",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100166575",
            "telephone_number": "212-759-2282",
            "fax_number": "212-379-2123"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "41 CLARK ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112012415",
            "telephone_number": "646-518-5566",
            "fax_number": "646-805-2946"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SURACH",
        "first_name": "NICOLE",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-11-14",
        "last_updated": "2019-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA01582300",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "0414921",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2019; 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.