NICOLLETTE PENNER DPT
NPI 1174155568
Physical Therapist in San Diego, CA

Active since February 04, 2020Accepts Medicare Assignment
15004 INNOVATION DRIVE, SAN DIEGO, CA 92128(858) 605-7189 Get Directions Write a Review

NPPES record last updated: February 4, 2020. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Nicollette Penner Dpt NPPES

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

NICOLLETTE PENNER DPT (NPI 1174155568) is an individual physical therapist in San Diego, California, licensed in California (292631) and active in the NPI registry since February 2020. She is a graduate of Other (2016).

NPPES Registry Identity

NPI1174155568
Entity TypeIndividualFemale
Primary Taxonomy225100000X
Provider Legal NameNICOLLETTE PENNERCredential: DPT
Location Address15004 INNOVATION DRIVESan Diego, CA 92128
Mailing Address10790 Rancho Bernardo Rd., Mail Drop 4s-205San Diego, CA 92127-5705 · (858) 927-5775
Sole ProprietorNo
Medical School CMSOtherGraduated 2016
Enumeration DateFebruary 4, 2020
NPI 1174155568 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
License Licensed in CA · 292631
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.
15004 INNOVATION DRIVE, San Diego, CA 92128

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare and accepts Medicare assignment

Nicollette Penner 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 ID840777058
PECOS Enrollment IDI20260120001013

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 92128 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
$94.87 typical visit price
range $62.10 – $184.71
Typical copayment $23.71 (range $15.52 – $46.17)
Most-billed visit code 99203
Established Patient
$76.87 typical visit price
range $20.62 – $151.42
Typical copayment $19.21 (range $5.15 – $37.85)
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 4

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

Physician Assistant (Medical)
15004 INNOVATION DRIVE
SAN DIEGO, CA 92128
Pediatrics
15004 INNOVATION DRIVE
SAN DIEGO, CA 92128
Nurse Practitioner (Family)
15004 INNOVATION DRIVE, --
SAN DIEGO, CA 92128
Physical Therapist
15004 INNOVATION DRIVE
SAN DIEGO, CA 92128

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Nicollette Penner's NPI number?

The NPI number for Nicollette Penner is 1174155568. It was assigned to this individual provider in the NPPES registry on February 4, 2020.

Where is Nicollette Penner located?

Nicollette Penner practices at 15004 Innovation Drive, San Diego, CA 92128. The listed phone number is (858) 605-7189.

What is Nicollette Penner's specialty?

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

Is Nicollette Penner enrolled in Medicare?

Yes. Nicollette Penner is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

When was this NPI record last updated?

The NPPES record for Nicollette Penner was last updated on February 4, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.