JACQUELINE NICHOLSON PT, DPT
NPI 1114430725
Physical Therapist in Jefferson, WI

Q: What is Jacqueline Nicholson's NPI number?

The NPI number for Jacqueline Nicholson is 1114430725. It was assigned to this individual provider in the NPPES registry on November 6, 2017.

Q: What is Jacqueline Nicholson's specialty?

The primary specialty registered for this NPI is Physical Therapist with taxonomy code 225100000X.

Active since November 06, 2017Accepts Medicare Assignment

1130 COLLINS RD, JEFFERSON, WI 53549(262) 470-6950(262) 470-6950 Get Directions Write a Review

NPPES record last updated: November 6, 2017. Verified against the NPPES registry weekly; last sync: October 18, 2026.

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About Jacqueline Nicholson Pt, Dpt NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JACQUELINE NICHOLSON PT, DPT (NPI 1114430725) is an individual physical therapist in Jefferson, Wisconsin and active in the NPI registry since November 2017. She is a graduate of Other (2016).

NPPES Registry Identity

NPI1114430725

Entity TypeIndividualFemale

Primary Taxonomy225100000X

Provider Legal NameJACQUELINE NICHOLSONCredential: PT, DPT

Location Address1130 COLLINS RDJefferson, WI 53549-2939

Mailing Address412 E Forest StOconomowoc, WI 53066-3708 · (262) 470-6950

Phone(262) 470-6950

Fax(262) 470-6950

Sole ProprietorNo

Medical School CMSOtherGraduated 2016

Enumeration DateNovember 6, 2017

✔ NPI 1114430725 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service Providers

Taxonomy Code225100000X

Definition

Physical therapists (PTs) are licensed health care professionals who diagnose and treat individuals of all ages, from newborns to the very oldest, who have medical problems or other health-related conditions that limit their abilities to move and perform functional activities in their daily lives. PTs examine each individual and develop a plan using treatment techniques to promote the ability to move, reduce pain, restore function, and prevent disability. In addition, PTs work with individuals to prevent the loss of mobility before it occurs by developing fitness- and wellness-oriented programs for healthier and more active lifestyles. PTs:

Diagnose and manage movement dysfunction and enhance physical and functional abilities.
Restore, maintain, and promote not only optimal physical function but optimal wellness and fitness and optimal quality of life as it relates to movement and health.
Prevent the onset, symptoms, and progression of impairments, functional limitations, and disabilities that may result from diseases, disorders, conditions, or injuries.
Treat conditions of the musculoskeletal, neuromuscular, cardiovascular, pulmonary, and/or integumentary systems.
Address the negative effects attributable to unique personal and environmental factors as they relate to human performance.

PTs provide care for people in a variety of settings, including hospitals, private practices, outpatient clinics, home health agencies, schools, sports and fitness facilities, work settings, and nursing homes. State licensure is required in each state in which a PT practices.

1130 COLLINS RD, Jefferson, WI 53549

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, UnitedHealthcare.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Jacqueline Nicholson Pt, Dpt is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID5496089591

PECOS Enrollment IDI20190624002265

Medicare Billing Reassignments

Medicare enrollment records show Jacqueline Nicholson reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Aegis Group Practice LLC

4.2 mi

Occupational Therapist

737 REENA AVE
Fort Atkinson, WI 53538

Reassigned Medicare billing, Wisconsin enrollment
63 clinicians in this Medicare group

NPI 1083551881 (479) 201-6037

Fox Rehabilitation Services Wi LLC

47 mi

Physical Therapist

250 E WISCONSIN AVE FL 18
Milwaukee, WI 53202

Reassigned Medicare billing, Wisconsin enrollment
187 clinicians in this Medicare group

NPI 1518483973 (877) 407-3422

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 5

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Therapy procedure using functional activities 97530

A therapy procedure using functional activities encourages you to use your own body movements in day-to-day tasks to aid recovery. It aims to improve your mobility, strength, and overall health by incorporating therapeutic exercises into your routine.

367 services26 patients

Therapy procedure using exercise to develop strength, endurance, range of motion, and flexibility, each 15 minutes 97110

This therapy involves exercises to boost strength, endurance, flexibility, and range of motion. Each session lasts 15 minutes. The goal is to improve physical function and overall health. It's a safe, beneficial method for enhancing well-being and fitness.

324 services25 patients

Therapy procedure for walking training, each 15 minutes 97116

Walking training therapy is a process to improve your ability to walk. It's a 15-minute session where you'll practice walking with the help of devices or exercises. It aims to enhance balance, strength, coordination, and endurance.

239 services21 patients

Therapy procedure to re-educate brain-to-nerve-to-muscle function, each 15 minutes 97112

This therapy helps retrain your brain, nerves, and muscles to work together. Through targeted exercises, your body learns to regain lost functions or improve current abilities. Each session lasts 15 minutes.

109 services20 patients

Evaluation for physical therapy, typically 30 minutes 97162

An evaluation for physical therapy is a 30-minute session where a physical therapist assesses your current physical condition. They'll examine your strength, flexibility, balance, and mobility to identify areas needing improvement. This helps tailor a therapy plan to your specific needs.

16 services13 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 53549 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$82.92 typical visit price

range $53.90 – $163.24

Typical copayment $20.73 (range $13.47 – $40.81)

Most-billed visit code 99203

Established Patient

$67.37 typical visit price

range $17.40 – $133.76

Typical copayment $16.84 (range $4.35 – $33.44)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 17

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ALDEN ESTATES OF COUNTRYSIDE, INC.

Clinic/Center (Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF))