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

Mrs. Jennifer Nicodemo-Capra, MA, PT

Individual provider Physical Therapist · NPI 1609922145

Mrs. Jennifer Nicodemo-Capra, MA, PT is a Physical Therapist in Private Practice in Coram, New York. Qualified in 1995, 31 years ago. Practices as a sole proprietor and accepts Medicare assignment. Licensed in New York.

Years since qualifying
31
Licensed in
NY
In the registry since
2007
Specialties on file
2
What do these letters mean?
MA — Master of Arts
A graduate arts degree.
PT — Physical Therapist
A licensed therapist who treats movement, pain and injury.

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Practice location Address checks out

2 Walton Way Lighthouse Physical Therapy P.c
Coram, NY 11727-1001
Phone: (631) 440-7678
Fax: (631) 331-0320
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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 015513 (NY)
Physical Therapist Taxonomy 225100000X · Licence 015513-1 (NY)

Record details

NPI number1609922145
Entity typeIndividual (Type 1)
GenderFemale
Credentials MA , PT
Sole proprietorYes
NPI enumeratedJanuary 26, 2007
Last updated in NPPESJuly 21, 2022

Medicare enrollment

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

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 1995 (31 years in practice)
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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