BRAD JAMES NICOLL P.T.
NPI 1376865337
Physical Therapist - Orthopedic in San Diego, CA

Q: What is Brad Nicoll's NPI number?

The NPI number for Brad Nicoll is 1376865337. It was assigned to this individual provider in the NPPES registry on February 18, 2010.

Q: What is Brad Nicoll's specialty?

The primary specialty registered for this NPI is Physical Therapist, specializing in Orthopedic, with taxonomy code 2251X0800X.

Q: When was this NPI record last updated?

The NPPES record for Brad Nicoll was last updated on March 18, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 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.

Active since February 18, 2010Accepts Medicare Assignment

15004 INNOVATION DR, SAN DIEGO, CA 92128(858) 605-7189 Get Directions Write a Review

NPPES record last updated: March 18, 2016. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Brad James Nicoll P.t. NPPES

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

BRAD JAMES NICOLL P.T. (NPI 1376865337) is an individual orthopedic provider in San Diego, California, licensed in California (36797) and active in the NPI registry since February 2010. He is a graduate of Other (2011).

NPPES Registry Identity

NPI1376865337

Entity TypeIndividualMale

Primary Taxonomy2251X0800X

Provider Legal NameBRAD JAMES NICOLLCredential: P.T.

Location Address15004 INNOVATION DRSan Diego, CA 92128-3491

Mailing Address10790 Rancho Bernardo Rd, Mail Drop 4s-205San Diego, CA 92127-5705 · (858) 927-5775

Phone(858) 605-7189

Sole ProprietorNo

Medical School CMSOtherGraduated 2011

Enumeration DateFebruary 18, 2010

Last NPPES UpdateMarch 18, 2016

✔ NPI 1376865337 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysical Therapist · OrthopedicRespiratory, Developmental, Rehabilitative and Restorative Service Providers

Taxonomy Code2251X0800X

License✔ Licensed in CA · 36797

Definition

A licensed physical therapist, including but not limited to an individual who is a Board Certified Specialist in Orthopaedic Physical Therapy, who has demonstrated specialized knowledge and skill in human anatomy and physiology, movement science; pathology/pathophysiology, pain science, medical and surgical considerations, orthopaedic physical therapy theory and practice, and critical inquiry for evidence-based practice.

15004 INNOVATION DR, San Diego, CA 92128

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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

Brad James Nicoll P.t. 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 ID1759680929

PECOS Enrollment IDI20160422001309

Other Providers at the Same Location NPPES 20

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

MS. MARGARET ANN FULLER

Occupational Therapist (Physical Rehabilitation)