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

Roxane Nicholson, PT

Individual provider Physical Therapist · NPI 1942878269

Roxane Nicholson, PT is a Physical Therapist in Private Practice in Newark, New York. Qualified in 1993, 33 years ago. Practices with Nysarc Inc, a 15-clinician group and accepts Medicare assignment. Licensed in New York.

Years since qualifying
33
Licensed in
NY
In the registry since
2021
Specialties on file
2
What do these letters mean?
PT — Physical Therapist
A licensed therapist who treats movement, pain and injury.

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Practice location Address checks out

150 Vanburen St
Newark, NY 14513
Phone: (315) 331-7741
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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 016024-01 (NY)
Physical Therapy Clinic/Center Taxonomy 261QP2000X · Licence 016024-01 (NY)

Record details

NPI number1942878269
Entity typeIndividual (Type 1)
GenderFemale
Credentials PT
Sole proprietorYes
NPI enumeratedJune 14, 2021
Last updated in NPPESOctober 21, 2024
Certification dateOctober 16, 2024
Mailing address508 Vienna St Lot 13, Newark, NY 14513-9160

Medicare enrollment

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

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 1993 (33 years in practice)
Group practice Nysarc Inc. — 15 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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