Nicole Evans, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

040939-1 Issued in NY

Practice address

124 E Main St
Babylon, NY 11702-3532

Phone

(631) 482-1344

Fax

(631) 482-1345

NPI assigned

Jan 9, 2017

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

New York UniversityGroup PAC ID 1355232422, 5,925 clinicians

Metro Physical Occupational Speech Massage Therapy and Acupuncture PLLGroup PAC ID 1254553639, 448 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Metro Physical Occupational Speech Massage Therapy & Acupuncture PLLC

  • Occupational Therapist
  • Garden City, NY
  • NPI 1356742365

  Physical Therapist

  Medicare reassignment Care Compare group NPD
• New York University

  dba NYU Faculty Group Practice

  • Cardiovascular Disease Physician
  • Boynton Beach, FL
  • NPI 1285826438

  NY

  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1483920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643846400000",
    "number": "1831635275",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "124 E MAIN ST",
            "city": "BABYLON",
            "state": "NY",
            "postal_code": "117023532",
            "telephone_number": "631-482-1344",
            "fax_number": "631-482-1345"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "124 E MAIN ST",
            "city": "BABYLON",
            "state": "NY",
            "postal_code": "117023532",
            "telephone_number": "631-482-1344",
            "fax_number": "631-482-1345"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EVANS",
        "first_name": "NICOLE",
        "credential": "PT, DPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-01-09",
        "last_updated": "2022-02-03",
        "certification_date": "2022-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "040939-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Eric Loughman PTPC (dynamic performance physical therapy)
• Jeff Ericksen, LMT
• Vanessa Taylor Escobedo, HIS
• Lynn Ann Estelle, CPNP
• Eva Khavkin Medical PC
• Joy Anne Fallick, RN
• Luis M Fandos, M.D.
• Kristen Bronde Farrelly, RD, CDN
• Henry I Ferdman, D.D.S.
• Olga Ferdman, DDS

• Physical Therapist in Babylon, NY
• Providers in Babylon, 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 Feb 3, 2022; 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.