Active NPI
Nicholas Collesano
- Orthopedic Physical Therapist
- Bridgewater, MA
National Provider Identifier
1922510759
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthopedic Physical Therapist
- License
- 23344
- Practice address
- 620 Bedford St
Bridgewater, MA 02324-3180 - Phone
- (508) 279-0033
- Fax
- (508) 279-0030
- NPI assigned
- Nov 2, 2017
- Last updated
- Nov 5, 2019
- 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 |
|---|---|---|---|---|
| Orthopedic Physical Therapist | 2251X0800X | 23344 | MA | Primary |
Addresses
Primary practice location
620 Bedford St
Bridgewater, MA 02324-3180
Mailing address
13616 California St
Ste 100
Omaha, NE 68154-5336
Phone (402) 496-0404
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 |
|---|---|---|---|
| 4029 | NE | MD | Mental Health Counselor |
| 23344 | MA | MD | Orthopedic Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Start Inc | Past | 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1509580800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1572912000000",
"number": "1922510759",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13616 CALIFORNIA ST",
"address_2": "STE 100",
"city": "OMAHA",
"state": "NE",
"postal_code": "681545336",
"telephone_number": "402-496-0404"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "620 BEDFORD ST",
"city": "BRIDGEWATER",
"state": "MA",
"postal_code": "023243180",
"telephone_number": "508-279-0033",
"fax_number": "508-279-0030"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COLLESANO",
"first_name": "NICHOLAS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-11-02",
"last_updated": "2019-11-05",
"status": "A"
},
"taxonomies": [
{
"code": "2251X0800X",
"taxonomy_group": "",
"desc": "Physical Therapist, Orthopedic",
"state": "MA",
"license": "23344",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bridgewater, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.