Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Jala Nicole Gilliam, DPT, PT

Individual provider Physical Therapist · NPI 1710606694

Jala Nicole Gilliam, DPT, PT is a Physical Therapist in Private Practice in Buffalo, New York. Qualified in 2022, 4 years ago. Practices with Advance Physical Therapy PC, a 10-clinician group and accepts Medicare assignment. Licensed in New York.

Years since qualifying
4
Licensed in
NY
In the registry since
2022
What do these letters mean?
DPT — Doctor of Physical Therapy
The doctoral degree now required to enter physical therapy practice.
PT — Physical Therapist
A licensed therapist who treats movement, pain and injury.

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Practice location Address checks out

2633 Main St
Buffalo, NY 14214-2096
Phone: (716) 342-1100
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X · Licence 049102 (NY)

Record details

NPI number1710606694
Entity typeIndividual (Type 1)
GenderFemale
Credentials DPT , PT
Sole proprietorNo
NPI enumeratedAugust 24, 2022
Last updated in NPPESOctober 1, 2022
Certification dateOctober 1, 2022

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 2022 (4 years in practice)
Group practice Advance Physical Therapy Pc — 10 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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